Sofia Ljunggren1, Stefan Winblad2, Ulla Hällgren Graneheim3, Kristina Malmgren4, Anneli Ozanne5. 1. Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University, Blå Stråket 7, SE-413 45 Göteborg, Sweden; Department of Neurology, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden. Electronic address: sofia.ljunggren@vgregion.se. 2. Department of Psychology, Gothenburg University, Box 500, SE-405 30 Göteborg, Sweden. Electronic address: Stefan.winblad@psy.gu.se. 3. Department of Health Care Sciences, University West, SE-461 32 Trollhättan, Sweden; Department of Nursing, Umeå University, SE-901 87 Umeå, Sweden. Electronic address: Ulla.hallgren.graneheim@umu.se. 4. Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University, Blå Stråket 7, SE-413 45 Göteborg, Sweden; Department of Neurology, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden. Electronic address: Kristina.malmgren@neuro.gu.se. 5. Department of Neurology, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, SE-413 45 Göteborg, Sweden. Electronic address: Anneli.ozanne@gu.se.
Abstract
PURPOSE: Frontal lobe resection (FLR) is the second most common epilepsy surgery procedure in adults. Few studies address neuropsychological consequences after FLR. The aim of this study was to explore patients' and relatives' experiences of cognitive, emotional and social cognitive functioning after frontal lobe epilepsy surgery. METHODS: Semi-structured interviews were held with 14 patients having gone through FLR as adults during the years 2000-2016 and 12 of their relatives. Interviews were audio-recorded, transcribed and analyzed with inductive qualitative content analysis. RESULTS: Positive as well as negative consequences were described both by patients and relatives. Feelings of relief and an increased capacity to experience emotions of well-being were mainly experienced as related to seizure freedom. A newfound autonomy and a more grown-up identity as opposed to a self-image based on epilepsy was also highlighted. However, results also showed that even for seizure free patients, FLR could give rise to negative experiences, the most prominent of which were mental fatigue, lowered mood and social withdrawal. Coping strategies included planning ahead to avoid mental exhaustion. Over all, respondents considered that the epilepsy surgery had been a risk well worth taking and that positive consequences outweighed the negative ones. CONCLUSIONS: This study shows a range of positive as well as negative outcomes after FLR for epilepsy. The findings indicate that lowered mood and mental fatigue could affect the life situation in a negative way, regardless of seizure outcome. This is important to consider in the preoperative counselling of patients and their families, as well as in the postsurgical follow-up. It is also crucial that the epilepsy surgery team has the possibility to offer rehabilitation and support to families regarding these aspects after surgery.
PURPOSE: Frontal lobe resection (FLR) is the second most common epilepsy surgery procedure in adults. Few studies address neuropsychological consequences after FLR. The aim of this study was to explore patients' and relatives' experiences of cognitive, emotional and social cognitive functioning after frontal lobe epilepsy surgery. METHODS: Semi-structured interviews were held with 14 patients having gone through FLR as adults during the years 2000-2016 and 12 of their relatives. Interviews were audio-recorded, transcribed and analyzed with inductive qualitative content analysis. RESULTS: Positive as well as negative consequences were described both by patients and relatives. Feelings of relief and an increased capacity to experience emotions of well-being were mainly experienced as related to seizure freedom. A newfound autonomy and a more grown-up identity as opposed to a self-image based on epilepsy was also highlighted. However, results also showed that even for seizure free patients, FLR could give rise to negative experiences, the most prominent of which were mental fatigue, lowered mood and social withdrawal. Coping strategies included planning ahead to avoid mental exhaustion. Over all, respondents considered that the epilepsy surgery had been a risk well worth taking and that positive consequences outweighed the negative ones. CONCLUSIONS: This study shows a range of positive as well as negative outcomes after FLR for epilepsy. The findings indicate that lowered mood and mental fatigue could affect the life situation in a negative way, regardless of seizure outcome. This is important to consider in the preoperative counselling of patients and their families, as well as in the postsurgical follow-up. It is also crucial that the epilepsy surgery team has the possibility to offer rehabilitation and support to families regarding these aspects after surgery.
Authors: Florian Johannes Mücke; Marc Petrus Hendriks; Christian Günther Bien; Philip Grewe Journal: Front Neurol Date: 2022-07-22 Impact factor: 4.086