Psychosocial outcome in epilepsy after extratemporal surgery
Walther K, Onugoren MD, Buchfelder M, Gollwitzer S, Graf W, Kasper B, Kriwy P, Kurzbuch K, Lang J, Roessler K, Schwab S, Schwarz M, Stefan H, Hamer H (2018)
Publication Type: Journal article
Publication year: 2018
Journal
Book Volume: 81
Pages Range: 94-100
DOI: 10.1016/j.yebeh.2018.01.038
Abstract
OBJECTIVE: Only limited data exist on psychosocial long-term outcome after epilepsy surgery in patients with extratemporal epilepsy. The aim of this study was to investigate psychosocial outcome after extratemporal epilepsy surgery and to assess factors predicting favorable outcome. METHOD: Sixty-five out of 104 eligible patients who had undergone extratemporal epilepsy surgery at our epilepsy center between 1990 and 2015 (mean age: 42.2. years; 75% of the resections in the frontal lobe) completed a questionnaire asking about seizure status, employment status, marital and living situation, driving status, depressive symptoms, and quality of life (QOL). Follow-up was on average 9.2years after surgery (range: 1-26years). RESULTS: Thirty-eight (58%) patients were free of disabling seizures (Engel class I), and 28 (43%) have not experienced any seizures after surgery (Engel class IA). Employment rate in the primary labor market remained at 45%, but more patients lost employment (14%) than gained employment (8%). Postoperative employment was predicted by preoperative employment (p=.007), seizure freedom (p=.025), older age at seizure onset (p=.018), younger age at follow-up (p=.035), and female gender (p=.048). Seizure-free patients were more likely to be driving; have a partner, particularly in males; and have lower depressive scores. Quality of life at follow-up was best predicted by employment (p=.012), partnership (p=.025), and seizure freedom (p=.025). In contrast, recurrence of seizures and early seizure onset were associated with poor psychosocial outcome, particularly in men. CONCLUSION: The study provides support that extratemporal surgery can lead to improved QOL and favorable psychosocial outcome. Seizure freedom is important but not the only determinant of good psychosocial outcome.
Authors with CRIS profile
Michael Buchfelder
Lehrstuhl für Neurochirurgie
Burkhard Kasper
Medizinische Fakultät
Katrin Kurzbuch
Medizinische Fakultät
Stefan Schwab
Lehrstuhl für Neurologie
Michael Schwarz
Department of Neurology
Hermann Stefan
Medizinische Fakultät
Hajo Hamer
Professur für Epileptologie
Involved external institutions
Germany (DE)How to cite
APA:
Walther, K., Onugoren, M.D., Buchfelder, M., Gollwitzer, S., Graf, W., Kasper, B.,... Hamer, H. (2018). Psychosocial outcome in epilepsy after extratemporal surgery. Epilepsy and Behavior, 81, 94-100. https://dx.doi.org/10.1016/j.yebeh.2018.01.038
MLA:
Walther, Katrin, et al. "Psychosocial outcome in epilepsy after extratemporal surgery." Epilepsy and Behavior 81 (2018): 94-100.
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