Quality of life in young adults who underwent resective surgery for epilepsy in childhood

Elliott, Irene; Kadis, Darren S.; Lach, Lucyna; Olds, Janet; McCleary, Lynn; Whiting, Sharon; Snyder, Thomas; Smith, Mary Lou

doi:10.1111/j.1528-1167.2012.03594.x

Cited by 44 publications

(46 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Seizure freedom in children leads to improved intellectual and cognitive ability [36], better memory function [30], fewer behavioral problems [33], decreased medication use and side effects [25,34], and is the most important predictor of quality of life [9,31]. Survey data have also suggested that Engel class I outcome is associated with higher levels of education, employment status, independence, and overall satisfaction compared to less favorable seizure outcomes [25,26].…”

Section: Discussionmentioning

confidence: 99%

“…Given that intractable seizures can lead to significant morbidity and increased risk of death, temporal lobectomy is an important treatment option for medically refractory TLE [11,28]. Complete seizure freedom is the ultimate goal in pediatric TLE surgery, as it is the most important predictor of quality of life in epilepsy treatment [9,31]. Unfortunately, 10-40 % of children continue to have seizures after temporal lobectomy [32,35].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of temporal lobectomy on consciousness-impairing and consciousness-sparing seizures in children

et al. 2013

View full text Add to dashboard Cite

Purpose Most children with medically refractory temporal lobe epilepsy (TLE) become seizure free after temporal lobectomy, but some individuals continue to seize. As studies of temporal lobectomy typically focus on seizure freedom, the effect of surgery on seizure type and frequency among children with persistent seizures is poorly understood. Seizures which impair consciousness are associated with increased morbidity compared to consciousness-sparing seizures. Methods A retrospective cohort study was performed to evaluate the effects of temporal lobectomy on seizure type and frequency in children with intractable TLE. Results Among 58 pediatric TLE patients with a mean (±SEM) age of 14.0±0.7 years who received temporal lobectomy, 46 (79.3 %) individuals achieved an Engel class I seizure outcome, including 38 (65.5 %) children who became completely seizure free (Engel IA). Mean follow-up was 2.7±0.4 years. While the number of patients experiencing simple partial seizures (SPSs) (consciousness sparing) decreased by only 23 % after surgery, the number of children having complex partial seizures and generalized tonic-clonic seizures (consciousness impairing) diminished by 87 and 83 %, respectively (p<0.01). SPS was the predominant seizure type in only 11.3 % of patients before resection, but in 42.1 % of patients with postoperative seizures (p<0.01). Children with postoperative seizures experienced a 70 % reduction in overall seizure frequency compared to baseline (p<0.05), having consciousnessimpairing seizures 94 % less frequently (p<0.05), but having consciousness-sparing seizures 35 % more frequently (p=0.73). Conclusions Seizure type and frequency are important considerations in the medical and surgical treatment of children with epilepsy, although complete seizure freedom remains the ultimate goal.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of temporal lobectomy on consciousness-impairing and consciousness-sparing seizures in children

et al. 2013

View full text Add to dashboard Cite

show abstract

“…The total score was calculated by weighing and summing up the product of the subscale scores. Higher scores reflected better quality of life and lower scores worse quality of life [39,40]. 4 control subjects and 3 intervention group subjects belonged to the age group below 18 years, and hence the QOLIE-31 score scale was used among 33 control subjects and 37 subjects in the reflexology group.…”

Section: Primary Outcome Measures and Response Calculationsmentioning

confidence: 99%

Role of Reflexology and Antiepileptic Drugs in Managing Intractable Epilepsy - a Randomized Controlled Trial

Dalal

Devarajan²,

Pandey³

et al. 2013

Complement Med Res

View full text Add to dashboard Cite

Background: This report is based on the results of a randomized parallel controlled trial conducted to determine the efficacy of reflexology therapy in managing intractable epilepsy. Methods: Subjects who failed epilepsy surgery or were not candidates for epilepsy surgery or were non-responders of antiepileptic drugs (AEDs) took part in this study. The trial was completed by 77 subjects randomly assigned to 2 arms: control (AEDs) and reflexology (AEDs + reflexology therapy). The hypothesis was that hand reflexology therapy could produce results similar to those of vagus nerve stimulation, and foot reflexology therapy could maintain homeostasis in the functional status of individual body parts. Reflexology therapy was applied by family members. The follow-up period was 1.5 years. Quality of life in epilepsy patients was assessed with the QOLIE-31 instrument. Results: In the reflexology group, the median baseline seizure frequency decreased from 9.5 (range 2-120) to 2 (range 0-110) with statistical significance (p < 0.001). In the control arm, the decrease was less than 25% with a baseline value of 16 (range 2-150). The pretherapy QOLIE-31 scores in the control group and the reflexology group were 41.05 ± 7 and 43.6 ± 8, respectively. Posttherapy data were 49.07 ± 6 and 65.4 ± 9, respectively (p < 0.002). The reflexology method allowed detection of knee pain in 85% of the reflexology group patients (p < 0.001), and 85.3% of patients derived 81% relief from it (p < 0.001). 4 reflexology group patients reported nausea/vomiting (n = 1), change in voice (n = 2), and hoarseness (n = 1). Conclusion: Reflexology therapy together with AEDs may help reducing seizure frequency and improving quality of life in individuals with epilepsy.

show abstract

“…About 10-50 % of the patients with DRE are amenable to surgical treatment [2]. The purpose of surgical resection is essentially seizure freedom, rather than seizure reduction as quality of life is linked to this outcome [3]. There are often additional benefits on neurodevelopment which can be considered a bonus and not a primary indication for surgery.…”

Section: Introductionmentioning

confidence: 99%

Trends in Pediatric Epilepsy Surgery

2015

View full text Add to dashboard Cite

Epilepsy surgery has become an accepted treatment for drug resistant epilepsy in infants and children. It has gained ground in India over the last decade. Certain epilepsy surgically remediable syndromes have been delineated and should be offered surgery earlier rather than later, especially if cognitive/behavioral development is being compromised. Advances in imaging, particularly in MRI has helped identify surgical candidates. Pre-surgical evaluation includes clinical assessment, structural and functional imaging, inter-ictal EEG, simultaneous video -EEG, with analysis of seizure semiology and ictal EEG and other optional investigations like neuropsychology and other newer imaging techniques. If data are concordant resective surgery is offered, keeping in mind preservation of eloquent cortical areas subserving motor, language and visual functions. In case of discordant data or non-lesional MRI, invasive EEG maybe useful using a two-stage approach. With multi-focal / generalized disease, palliative surgery like corpus callosotomy and vagal nerve stimulation maybe useful. A good outcome is seen in about 2/3rd of patients undergoing resective surgery with a low morbidity and mortality. This review outlines important learning aspects of pediatric epilepsy surgery for the general pediatrician.

show abstract

Quality of life in young adults who underwent resective surgery for epilepsy in childhood

Cited by 44 publications

References 51 publications

Effects of temporal lobectomy on consciousness-impairing and consciousness-sparing seizures in children

Effects of temporal lobectomy on consciousness-impairing and consciousness-sparing seizures in children

Role of Reflexology and Antiepileptic Drugs in Managing Intractable Epilepsy - a Randomized Controlled Trial

Trends in Pediatric Epilepsy Surgery

Contact Info

Product

Resources

About