Quality of life in patients with epilepsy caused by hippocampal sclerosis: a comparison of surgical and non-surgical approaches

Abstract

Background. Epilepsy associated with hippocampal sclerosis is a significant neurological issue that substantially impairs patients’ quality of life. Surgical treatment is considered an effective method for improving people’s state; however, its impact on quality of life remains underexplored. Objective: to assess the impact of surgical intervention on the quality of life of patients with epilepsy caused by hippocampal sclerosis by studying the factors that influence it and comparing outcomes between operated and non-operated patients. Materials and methods. The study involved 100 patients treated at the Regional Clinical Center of Neurosurgery and Neurology in Uzhhorod from 2014 to 2020. Quality of life was assessed using the QOLIE-31-P scale, cognitive and emotional functions were evaluated using the Montreal Cognitive Assessment Test, Beck Depression Inventory, and other methods. Statistical analysis was performed using the t-test, Pearson correlation coefficient, and chi-square test. Results. Patients who underwent surgical treatment for hippocampal sclerosis showed a higher level of overall quality of life: 66.0 ± 14.8 compared to 58.2 ± 13.3 in non-operated patients (p = 0.008). Disease duration before intervention and patient’s age at the time of surgery correlated with quality of life (r = –0.45, p < 0.01; r = –0.42, p < 0.01, respectively). The number of epileptiform discharges on preoperative EEG correlated with poorer quality of life (r = –0.36, p < 0.05). Polytherapy had mixed effects: negative one on cognitive functions but positive one on anxiety and depression levels. Conclusions. Surgery can improve the quality of life in patients with hippocampal sclerosis. Early surgical intervention may lead to better outcomes highlighting the importance of timely and individualized treatment approaches.