Postoperative Quality of Life Outcome and Employment in Patients Undergoing Resection of Epileptogenic Lesions Detected by Magnetic Resonance Imaging

Abstract

The long-term postoperative improvement of quality of life (QOL) and employment were investigated in patients undergoing resection of epileptogenic lesions detected by magnetic resonance (MR) imaging to identify the associated preoperative factors. Thirty of 47 patients who underwent lesionectomy between 1987-2001 replied to questionnaires. Patients with extratemporal resection outnumbered those with temporal lobe resection. The mean follow-up period was 12.4 ± 3.7 years. An arbitrary score for quantitatively assessing QOL was assigned. The mean increases in QOL score points were significantly higher in the late childhood onset group than those in the early childhood onset group, and were also significantly higher in the temporal resection group and extratemporal resection of non-dysplastic cortical pathology group than in the extratemporal resection of dysplastic cortical pathology group. Postoperative QOL improvement and occupational status of patients depended on the completeness of seizure control. Resection of lesions detected by MR imaging in patients with intractable epilepsy resulted in effective long-term QOL improvement and postoperative occupational status. Favorable outcome was related mainly to the pathology of the epileptogenic lesions, whether the lesion site was temporal or extratemporal, and the completeness of seizure control.

Spectrum of surgical complications of temporal lobe epilepsy surgery: a single-center study

“…Surgical removal of the epileptic focus has been approved as an effective therapy for patients with seizures that may be focal in origin, that are continuing to occur despite treatment with antiepileptic drugs (AEDs), and whose quality of life (QOL) is significantly impaired by epilepsy. The primary goal of epilepsy surgery (ES) is for the patient to be able to lead a seizure-free life, and preferably discontinuation or reduction of AEDs (2,8,17,22). However, similar to all of the other neurological surgeries, peri-and post-surgical complications may also accompanied with ESs, and physicians should always be aware of these complications in order to facilitate the assessment of the risk/benefit ratio of ES.…”

Long-Term Seizure Outcome Following Resective Surgery for Epilepsy: To be or Not to be Completely Cured?

“… 27) The elimination of seizures by surgical intervention would be expected to decrease mortality in addition to providing opportunities for improved self-esteem, greater social opportunity, and even career advancement. 25) Spencer and Huh reviewed that 48–84% of patients were seizure-free after temporal lobe resection: 66–70% at short-term (less than 5 years) and 41–79% at long-term (more than 5 years) follow-up. On the other hand, 36–76% of patients were seizure-free after neocortical resection.…”

Socioeconomic outcome of epilepsy surgery: A controlled national study

“…Epilepsy surgery is associated with positive but also potentially negative psychological and cognitive effects [6][7][8][9][10], for which reason there is a need for more research and supportive intervention [7]. A number of studies have addressed the social outcome of epilepsy surgery; in general, freedom from seizure tends to be a positive factor for outcome measures, but there is a lack of controlled trials and of evaluations of factual social outcome as determined by education and employment [7,9,[11][12][13]. As such, a national estimate of social outcome compared with a control group has not previously been attempted.…”