Quality of life long after temporal lobe epilepsy surgery

Benevides, Maria Luiza; Nunes, Jean Costa; Guarnieri, Ricardo; Pauli, Carla; Wolf, Peter; Lunardi, Mariana dos Santos; Kondageski, Charles; Linhares, Marcelo Neves; Lin, Kátia; Walz, Roger

doi:10.1111/ane.13406

Cited by 15 publications

(26 citation statements)

References 31 publications

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“…A prospective study of children who underwent temporal lobe epilepsy surgery showed that seizure freedom was a good predictor of QoL, whereas preoperative factors could not predict QoL ( 24 ). In accordance with the results, our study found that preoperative factors, such as preoperative seizure type, seizure frequency, and anti-epileptic drugs (AEDs), were not statistically associated with QoL.…”

Section: Discussionmentioning

confidence: 99%

Quality of life of children with residual seizures after epileptic resection surgery

Zhang

Liang

et al. 2022

Front. Neurol.

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ObjectiveEpilepsy dramatically affects the quality of life (QoL) of children, and resection surgery can improve their QoL by reducing seizures or completely controlling them. Children who have postoperative seizures tend to show a poorer QoL. The aim of the present study was to investigate the QoL of children with seizures after resection surgery and its influencing factors.MethodsIn the present study, we retrospectively reviewed 151 consecutive children who underwent resection surgery. We then divided them into two groups, seizure and seizure-free groups, according to the seizure outcomes 1 year after surgery. Variables were categorized into a number of factor types such as preoperative factors, surgery-related factors, postoperative factors, and family factors. QoL and seizure outcomes more than 3 years after surgery were assessed according to the ILAE seizure outcome classification and the CHEQOL-25 scale.ResultsForty-three (28.5%) of the 151 children had seizures 1 year after surgery, and two children died during the follow-up period. The mean CHEQOL-25 scale for children with seizures was 63.5 ± 18.2, and 20 (48.8%) patients had poor QoL. Surgery-related factors, such as surgical complications and surgical sequelae, were not statistically associated with QoL. Preoperative language development retardation or language dysfunction [odds ratio (OR) = 29.3, P = 0.012) and postoperative ILAE seizure outcome classification (OR = 1.9, P = 0.045)] were significantly associated with QoL.SignificanceChildren with seizures after resection surgery had a relatively poor QoL. Surgery-related factors, such as surgical complications and surgical sequelae, cannot predict the QoL. Preoperative language development retardation or language dysfunction and postoperative ILAE seizure outcome classification were independent predictors of the quality of life (QoL). For children who could not achieve the expected freedom from seizure after surgery, a lower ILAE grade (ILAE 1-3) is also an acceptable outcome since it predicts a higher QoL.

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Section: Discussionmentioning

confidence: 99%

Quality of life of children with residual seizures after epileptic resection surgery

Zhang

Liang

et al. 2022

Front. Neurol.

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“…TLE patients present with cognitive defects, decreased attention, and functional connectivity decline as well as seizures [ 3 , 4 , 5 ]. TLE significantly interferes with the quality of daily life of patients because these patients often have cognitive, psychiatric, and behavioral problems that affect work and relationships [ 6 ]. From the perspective of clinical practice, TLE is currently particularly challenging to treat owing to frequent resistance to multiple traditional antiepileptic drugs [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Blocking ERK-DAPK1 Axis Attenuates Glutamate Excitotoxicity in Epilepsy

Gan

Zou

Chen

et al. 2022

IJMS

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Glutamate excitotoxicity induces neuronal cell death during epileptic seizures. Death-associated protein kinase 1 (DAPK1) expression is highly increased in the brains of epilepsy patients; however, the underlying mechanisms by which DAPK1 influences neuronal injury and its therapeutic effect on glutamate excitotoxicity have not been determined. We assessed multiple electroencephalograms and seizure grades and performed biochemical and cell death analyses with cellular and animal models. We applied small molecules and peptides and knocked out and mutated genes to evaluate the therapeutic efficacy of kainic acid (KA), an analog of glutamate-induced neuronal damage. KA administration increased DAPK1 activity by promoting its phosphorylation by activated extracellular signal-regulated kinase (ERK). DAPK1 activation increased seizure severity and neuronal cell death in mice. Selective ERK antagonist treatment, DAPK1 gene ablation, and uncoupling of DAPK1 and ERK peptides led to potent anti-seizure and anti-apoptotic effects in vitro and in vivo. Moreover, a DAPK1 phosphorylation-deficient mutant alleviated glutamate-induced neuronal apoptosis. These results provide novel insight into the pathogenesis of epilepsy and indicate that targeting DAPK1 may be a potential therapeutic strategy for treating epilepsy.

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“…These outcomes can be assessed by examining patient satisfaction with their experience of, and outcome following epilepsy surgery [2][3][4]. While there may be an association between postoperative seizure freedom and improvements in quality of life [5], the two outcomes are by no means perfectly correlated and a significant proportion of people with epilepsy can struggle to adjust to the 'burden of normality' once surgery has rendered them seizure free [6,7]. Similarly, some people who continue to experience seizures following surgery, nevertheless report improvements in quality of life following their operation.…”

Section: Introductionmentioning

confidence: 99%