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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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Self-assessment after surgery for mesial temporal lobe epilepsy – Quality of life and seizure control

Selbsteinschätzung nach Chirurgie bei mesialer Temporallappenepilepsie – Lebensqualität und Anfallskontrolle

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  • corresponding author Marec von Lehe - Neurochirurgische Klinik, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105 Bonn
  • H. Clusmann - Neurochirurgische Klinik, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105 Bonn
  • T. Kral - Neurochirurgische Klinik, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105 Bonn
  • J. Schramm - Neurochirurgische Klinik, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105 Bonn

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMI.03.12

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0269.shtml

Published: April 23, 2004

© 2004 von Lehe et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective

Seizure control has been established as main outcome parameter after epilepsy surgery. It is unclear, whether seizure relief corresponds with improvements in daily activity, mood, social life, and cognitive functioning. The significance of these lesser characterised outcome parameters may be underestimated, especially with regard to socio-economic integration.

Methods

140 patients underwent amygdalohippocampectomy for treatment of mesial temporal lobe epilepsy (MTLE). A questionnaire, similar and adjusted to the ESI-55 was completed by 128 patients (91.4%) at 17-53 months after surgery, in order to assess different aspects of individual functioning.

Results

Satisfactory seizure control was achieved in 108 patients (Engel I+II; 84,4%); unsatisfactory results in 20 patients (Engel III+IV; 15,6%). Of 108 patients with satisfactory seizure control 99 patients (92,7%) stated that their overall quality of live (QOL) was good or even very good after surgery. With unsatisfactory seizure control only 9 of 20 (45%) reported good or very good QOL after surgery (p<0,001). Moreover, 98 of 108 patients (90,7%) claimed improvements in QOL after epilepsy surgery. Self-assessment of more detailed neuropsychological functions revealed a significant correlation of cognitive and mnestic functioning with seizure control (p<0.001). Mood was significantly better with satisfactory seizure relief (p<0.001). Physical capabilities and social situation showed a significant trend towards better results with seizure relief (p= 0.03 and p=0.04, respectively). There was no correlation between age and self-assessed QOL. Reduction of anti-epileptic medication post-operatively was associated with better QOL. QOL, however, was dependent on the situation regarding job and family, but we found no significant correlation between these socio-economic aspects and seizure outcome after surgery.

Conclusions

The individual overall benefit after epilepsy surgery is difficult to assess. Definitely, seizure control correlates with patient satisfaction, but also other factors seem to have an impact on QOL after epilepsy surgery, which should not be neglected in the evaluation of patients undergoing functional neurosurgery.