Abstract
Aim
The aim of the study was evaluation of surgical treatment of epilepsy measured by changes in quality of life (QOL) and in seizure frequency and severity.
Materials and methods
Examined group consists of 24 boys and 9 girls. We performed corpus callosotomy, lesionectomy, vagal nerve stimulation, temporal lobectomy and multiple subpial transections. Age at surgery ranged from 5 months to 19 years, with mean follow-up of 11.9 months. QOL was evaluated on the basis of the questionnaire created by us, in which parents were asked to assess the following variables before and after the surgical procedure: communication, socialization, daily living skills, movement abilities and behavioural problems. The seizure frequency was assessed with the Engel’s scale, the modified Engel’s scale and the Seizure Scoring System. Clinical state of all the patients was evaluated as well.
Results
There were no patients with stable and worsening QOL status. In the whole group treated with callosotomy, the considerable improvement in QOL concerned 36.4% of cases. In more than 95% of cases, the reduction in seizures frequency is greater than 75%. In more than 43% of patients, there are no seizures after surgery.
Conclusions
Surgical treatment of intractable epilepsy is an effective method in terms of both seizure control and QOL improvement. Our results indicate the improvement in QOL of all operated patients. The improvement in QOL was accompanied by decrease in frequency and ‘positive’ changes in morphology of seizures. Improvement in QOL, as equivalent to seizure reduction rate, may influence further differentiation of qualification methods and surgical procedures of epilepsy.
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References
Baker GA, Jacoby A (eds) (2003) Review of quality of life in epilepsy: beyond seizure counts in assessment and treatment (book review). Seizure 12:191–192
Benbadis SR, Heriaud E, Tatum WO, Vale FL (2003) Epilepsy surgery, delays and referral patterns—are all your epilepsy patient controlled? Seizure 12:167–170
Bjornaes H, Stabell KE, Henriksen O, Roste G, Lien My Diep (2002) Surgical versus medical treatment for severe epilepsy: consequences for intellectual functioning in children and adults. Seizure 11:473–482
Britton JW, Cascino GD, Sharbrough FW, Kelly PJ (1994) Low-grade glial neoplasms and intractable partial epilepsy: efficacy of surgical treatment. Epilepsia Nov–Dec; 35(6):1130–1135
Engel J Jr, Van Ness PC, Rasmussen TB, Ojemann LM (1994) Outcome with respect to epileptic seizures. In: Engel J Jr (ed) Surgical treatment of epilepsies. Raven, New York, pp 609–622
Engel J (2003) A greater role for surgical treatment of epilepsy: why and when? Epilepsy Curr 3(2)37–40
Granata T, Gobbi G, Spreafico R, Vigevano F, Capovilla G, Ragona F, Freri E, Chiapparini L, Bernasconi B, Giordano L, Bertani G, Casazza M, Bernardina DB, Fusco L (2003) Rasmussen’s encephalitis. Neurology 60:422–425
Hallbook T, Lundgren J, Stjernqvist K, Blennow G, Stromblad LG, Rosen I (2005) Vagus nerve stimulation in 15 children with therapy resistant epilepsy; its impact on cognition, quality of life, behaviour and mood. Seizure 14(7):504–513
Jarrar RG, Buchhalter JR, Meyer FB, Sharbrough FW, Laws E (2002) Long-term follow-up of temporal lobectomy in children. Neurology 59:1635–1637
Martin R, Sawrie S, Gilliam F, Mackey M, Faught E, Knowlton R, Kuzniekcy R (2002) Determining reliable cognitive change after epilepsy surgery. Epilepsia 43:1551–1558
Mcewan MJ, Colin A Espie, Metcalfe J, Brodie MJ, Wilson MT (2004) Quality of life and psychosocial development in adolescents with epilepsy: a qualitative investigation using focus group methods. Seizure 13:15–31
Olavarria G, Petronio JA (2003) Epilepsy surgery in infancy. Pediatr Neurosurg 39:44–49
Sperling MR, Feldman H, Kinman J, Liporace JD, O’Connor MJ (1999) Seizure control and mortality in epilepsy. Ann Neurol 46:45–50
Swinkels WAM, Duijsens IJ, Spinhoven Ph (2003) Personality disorder traits in patients with epilepsy. Seizure 12(8):587–594
Blume WT (2003) Diagnosis and management of epilepsy. CMAJ 168(4):441–448
Wieser HG, Blume WT, Fish D, Goldensohn E, Hufnagel, King D, Sperling MR, Lueders H (2001) ILAE Commission Report. Proposal for a new classification of outcome with respect to epileptic seizures following epilepsy surgery. Epilepsia 42(2):282–286
Yang TF, Wong TT, Kwan SY, Chang KP, Lee YC, Hsu TC (1996) Quality of life and life satisfaction in families after a child has undergone corpus callosotomy. Epilepsia 37(1):76–80
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Larysz, D., Larysz, P. & Mandera, M. Evaluation of quality of life and clinical status of children operated on for intractable epilepsy. Childs Nerv Syst 23, 91–97 (2007). https://doi.org/10.1007/s00381-006-0200-x
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DOI: https://doi.org/10.1007/s00381-006-0200-x