PURPOSE: To assess the seizure-freedom rates and self-perceived psychosocial changes associated with the long-term outcome of epilepsy surgery in patients with refractory medial temporal lobe epilepsy associated with hippocampal sclerosis. METHODS: A standard questionnaire was given to 183 patients who underwent surgery between 1988 and 2004, and 110 were completed. RESULTS: The mean duration of follow-up after surgery was 7 years, with a maximum of 17 years. The probability that patients were seizure-free after surgery was dependent on the definition of the seizure freedom. For the patients who were seizure-free since surgery (Engel's class Ia), the probability was 97.6% at 1 year after surgery, 85.2% at 2 years after surgery, 59.5% at 5 years after surgery, and 42.6% at 10 years after surgery. For the patients who still experienced rare disabling seizures after surgery but were seizure-free at least 1 year before the time of assessment, the probability was of 97.6% at 1 year after surgery, 95% at 2 years after surgery, 82.8% at 5 years after surgery, and 71.1% at 10 years after surgery. The psychosocial long-term outcome, as measured by indices of driving, employment, familial and social relationships, and marital status, was similar to the psychosocial short-term outcome. It did not depend on seizure freedom or on follow-up time interval and was not influenced statistically by seizure frequency in cases of persisting seizures. Most but not all patients noticed a substantial overall improvement in their psychosocial condition; 48% drove (increased by 7%), 47% improved (14% worsened) in their employment status, and 68% improved (5% worsened) in their familial and social relationships. Overall, 91% of patients were satisfied with the surgery, and 92% did not regret their decision. CONCLUSIONS: The results of this study suggest that temporal lobe surgery has real long-term benefits. Two specific conclusions emerge: (a) the long-term rates of freedom from seizure depend on how seizure freedom is defined, and (b) the psychosocial long-term outcome does not change dramatically over years and does not depend on seizure freedom.
PURPOSE: To assess the seizure-freedom rates and self-perceived psychosocial changes associated with the long-term outcome of epilepsy surgery in patients with refractory medial temporal lobe epilepsy associated with hippocampal sclerosis. METHODS: A standard questionnaire was given to 183 patients who underwent surgery between 1988 and 2004, and 110 were completed. RESULTS: The mean duration of follow-up after surgery was 7 years, with a maximum of 17 years. The probability that patients were seizure-free after surgery was dependent on the definition of the seizure freedom. For the patients who were seizure-free since surgery (Engel's class Ia), the probability was 97.6% at 1 year after surgery, 85.2% at 2 years after surgery, 59.5% at 5 years after surgery, and 42.6% at 10 years after surgery. For the patients who still experienced rare disabling seizures after surgery but were seizure-free at least 1 year before the time of assessment, the probability was of 97.6% at 1 year after surgery, 95% at 2 years after surgery, 82.8% at 5 years after surgery, and 71.1% at 10 years after surgery. The psychosocial long-term outcome, as measured by indices of driving, employment, familial and social relationships, and marital status, was similar to the psychosocial short-term outcome. It did not depend on seizure freedom or on follow-up time interval and was not influenced statistically by seizure frequency in cases of persisting seizures. Most but not all patients noticed a substantial overall improvement in their psychosocial condition; 48% drove (increased by 7%), 47% improved (14% worsened) in their employment status, and 68% improved (5% worsened) in their familial and social relationships. Overall, 91% of patients were satisfied with the surgery, and 92% did not regret their decision. CONCLUSIONS: The results of this study suggest that temporal lobe surgery has real long-term benefits. Two specific conclusions emerge: (a) the long-term rates of freedom from seizure depend on how seizure freedom is defined, and (b) the psychosocial long-term outcome does not change dramatically over years and does not depend on seizure freedom.
Authors: Brigid E Prayson; Darlene P Floden; Lisa Ferguson; Kevin H Kim; Lara Jehi; Robyn M Busch Journal: Epilepsy Behav Date: 2017-01-28 Impact factor: 2.937
Authors: Krzysztof A Bujarski; Fuyuki Hirashima; David W Roberts; Barbara C Jobst; Karen L Gilbert; Robert M Roth; Laura A Flashman; Brenna C McDonald; Andrew J Saykin; Rod C Scott; Eric Dinnerstein; Julie Preston; Peter D Williamson; Vijay M Thadani Journal: J Neurosurg Date: 2013-04-26 Impact factor: 5.115
Authors: Yanrong Zhang; Haiyan Zhou; Haibo Qu; Chengde Liao; Hong Jiang; Siqin Huang; Sara Natasha Ghobadi; Arsenii Telichko; Ningrui Li; Frezghi G Habte; Tim Doyle; James P Woznak; Edward H Bertram; Kevin S Lee; Max Wintermark Journal: Ultrasound Med Biol Date: 2020-02-17 Impact factor: 2.998
Authors: Yanrong Zhang; Paul S Buckmaster; Lexuan Qiu; Jing Wang; Olivier Keunen; Sara Natasha Ghobadi; Ai Huang; Qingyi Hou; Ningrui Li; Shivek Narang; Frezghi G Habte; Edward H Bertram; Kevin S Lee; Max Wintermark Journal: Exp Neurol Date: 2021-05-12 Impact factor: 5.620
Authors: Midhun Mohan; Simon Keller; Andrew Nicolson; Shubhabrata Biswas; David Smith; Jibril Osman Farah; Paul Eldridge; Udo Wieshmann Journal: PLoS One Date: 2018-05-16 Impact factor: 3.240