Long-term seizure, quality of life, depression, and verbal memory outcomes in a controlled, mesial temporal lobe epilepsy surgical series using Portuguese-validated instruments.

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Long-term seizure, quality of life, depression, and verbal memory outcomes in a controlled, mesial temporal lobe epilepsy surgical series using Portuguese-validated instruments.

World Neurosurg. 2017 May 11;:

Authors: Dias L, Angelis G, Teixeira W, Casulari L

Abstract
OBJECTIVE: We aimed to evaluate long-term surgical outcomes in patients treated for mesial temporal lobe epilepsy (MTLE) compared to a similar group of patients that underwent a preoperative evaluation.
METHODS: Patient interviews were conducted by an independent neuropsychologist and included a socio-demographic questionnaire and validated versions of the Beck Depression Inventory-II (BDI-II), Adverse Events Profile (AEP), Quality of Life in Epilepsy-31 (QOLIE-31), and Rey Auditory Verbal Learning Test (RAVLT).
RESULTS: Seventy-one patients who underwent surgery and 20 who underwent MTLE preoperative evaluations were interviewed. After an 81-month mean postoperative follow-up, 44% of the surgical patients achieved complete seizure relief according to Engel's classification and 68% according to ILAE's. The surgical group had a significantly lower prevalence of depression (p = 0.002) and drug-related adverse effects (p = 0.002). Improvement on unemployment (p = 0.02) was achieved but not on driving or education. Delayed verbal memory recall was impaired in 76% of the surgical and 65% of the control cases (p = 0.32). Regarding the QOLIE-31, the operated patients scored higher in their total score (M = 75.44 vs. M = 60.08, p < 0.001) and in all but the cognitive functioning domain irrespective of the follow-up length. Seizure control, Beck's depression score, and AEP severity explained 73% of the variance in the surgical group QOL.
CONCLUSION: Our study found that, while surgical treatment was effective, its impact on social indicators was modest. Moreover, the self-reported QOL relied not only on seizure control but also on depressive symptoms and AED burden.

PMID: 28502691 [PubMed - as supplied by publisher]

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