WASHINGTON, DC—Resective surgery may reduce seizures for the majority of patients with epilepsy, according to research presented at the 67th Annual Meeting of the American Epilepsy Society. The procedure may also improve patients’ daily functioning and social and emotional well-being.
To investigate the effect of epilepsy surgery on patients’ lives, researchers from the Comprehensive Epilepsy Program at the Henry Ford Hospital in Detroit conducted a long-term retrospective follow-up of surgical patients. The team correlated postsurgical psychosocial outcomes with seizure outcome and brain area that had been treated surgically.
The investigators conducted telephone interviews with more than half of all patients who had undergone epilepsy surgery at their center between 1993 and 2011. During the interviews, the researchers assessed current seizure frequency and psychosocial metrics such as driving, employment, and use of antidepressants. Of the respondents, 215 patients had undergone temporal lobe surgery and 38 had had surgery on other brain areas. The investigators recorded demographics, age at epilepsy onset and surgery, seizure frequency before surgery, and pathology.
Of the 253 patients surveyed, 32% were seizure-free and 75% had a favorable outcome (ie, Engel Class I or II). More than three-fourths of patients who had undergone temporal lobe surgery (78%) had a favorable outcome, and more than half of patients who had had extratemporal surgery (58%) had a similar outcome. Almost all patients (92%) considered the surgery to have been worthwhile.
Half of the surgical patients (51%) were able to drive at the time of the survey, compared with 35% who were able to do so preoperatively. But after surgery, patients were less likely to be currently working full time, compared with before surgery (23% vs 42%). The difference in current full-time employment was significantly greater in patients with temporal resections, compared with patients with extratemporal resections (45% vs 26%).
In addition, more patients used antidepressants after surgery (30% vs 22%). Patients with a favorable surgical outcome were more likely than those with less favorable outcomes to be currently driving (65% vs 11%), more likely to be currently working (28% vs 8%), and less likely to be taking antidepressant medication (24% vs 47%).
“Our study shows that resective epilepsy surgery not only yields favorable seizure outcomes, but [favorable] psychosocial outcomes as well,” said Vibhangini S. Wasade, MD, a neurologist at the Henry Ford Health System and lead author of the study. “Following surgery, more patients were able to drive, and those with favorable seizure outcomes were more likely to be employed full-time and less likely to be taking antidepressants. Overall, the great majority expressed satisfaction in having epilepsy surgery.”
—Erik Greb