Employment outcome and satisfaction after anterior temporal lobectomy for refractory epilepsy: a developing country's perspective.

We examined employment outcome and its determinants in 172 south Indian patients who had undergone anterior temporal lobectomy (ATL) for medically refractory epilepsy. Despite seizure-free outcome in the majority, a significant change in post-ATL employment status occurred only in those involved in skilled jobs. Although factors such as younger age at surgery, shorter duration of epilepsy, longer post-ATL follow-up duration, and lower income were associated with favorable employment outcome in univariate analysis, only shorter duration of epilepsy was independently predictive in the multivariate model. A majority of homemakers appreciated marked improvement in their own day-to-day activities. Our patients did not express their desire to work as a principal aim of epilepsy surgery. To enhance occupational attainment, patients require, before epilepsy surgery, occupational assessment to identify their individual abilities and limitations and counseling in formulating realistic goals. After surgery, they require continued support in vocational training and job seeking.