Health related quality of life and seizure control in temporal lobe epilepsy

被引:149
作者
McLachlan, RS
Rose, KJ
Derry, PA
Bonnar, C
Blume, WT
Girvin, JP
机构
[1] UNIV WESTERN ONTARIO,DEPT CLIN NEUROL SCI,LONDON,ON,CANADA
[2] UNIV WESTERN ONTARIO,DEPT PSYCHOL,LONDON,ON,CANADA
关键词
OF-LIFE; PSYCHOSOCIAL ADJUSTMENT; FOLLOW-UP; LOBECTOMY; SURGERY; OUTCOMES; PEOPLE; IMPACT; SCALE;
D O I
10.1002/ana.410410411
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We conducted a prospective study over 24 months to compare health-related quality of life in surgically and medically treated patients with intractable temporal lobe epilepsy. Seizure frequency and health-related quality of life were assessed in 81 patients before and 6, 12, and 24 months after treatment. Using the Epilepsy Surgery Inventory 55 (ESI-55), we compared (1) different seizure outcome groups and (2) temporal lobectomy with continuing medical management. Follow-up was satisfactory in 72 patients (89%), 51 treated with temporal lobectomy and 21 with no surgery. Pretreatment seizures and health-related quality of life were comparable in the two groups. Seizure outcome was significantly better at 6, 12, and 24 months after surgery. At 24 months, seizure-free patients and those with at least a 90% reduction in seizure frequency reported significant improvements in health-related quality of life (on 5 of 10 subscales and overall Epilepsy Surgery Inventory 55 scale). Deterioration in quality of life occurred with less than 90% seizure reduction. Only one Epilepsy Surgery Inventory 55 subscale at 6 months and two subscales at 12 months showed a significant difference. Patients with good seizure outcome experience improved health-related quality of life after treatment. Since temporal lobectomy results in considerably better seizure control than continued medical management, the findings support surgery as the preferred treatment, although changes in health-related quality of life may not be evident until the second postoperative year.
引用
收藏
页码:482 / 489
页数:8
相关论文
共 42 条
[1]  
[Anonymous], EPILEPSY SURG
[2]   DEVELOPMENT OF A NOVEL SCALE TO ASSESS LIFE FULFILLMENT AS PART OF THE FURTHER REFINEMENT OF A QUALITY-OF-LIFE MODEL FOR EPILEPSY [J].
BAKER, GA ;
JACOBY, A ;
SMITH, DF ;
DEWEY, ME ;
CHADWICK, W .
EPILEPSIA, 1994, 35 (03) :591-596
[3]   QUALITY OF LIFE, HEALTH-STATUS, AND CLINICAL RESEARCH [J].
BERGNER, M .
MEDICAL CARE, 1989, 27 (03) :S148-S156
[4]   EFFECTIVENESS OF TEMPORAL LOBECTOMY MEASURED BY YEARLY FOLLOW-UP AND MULTIVARIATE-ANALYSIS [J].
BLUME, WT ;
DESAI, HB ;
GIRVIN, JP ;
MCLACHLAN, RS ;
LEMIEUX, JF .
JOURNAL OF EPILEPSY, 1994, 7 (03) :203-214
[5]   PRINCIPLES OF CLINICAL INVESTIGATION OF SURGICAL PATIENTS [J].
BLUME, WT .
INTERNATIONAL ANESTHESIOLOGY CLINICS, 1986, 24 (03) :47-74
[6]   QUALITY-OF-LIFE - CONCEPTS AND DEFINITION [J].
CELLA, DF .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 1994, 9 (03) :186-192
[7]   PSYCHOSOCIAL FUNCTION FOLLOWING TEMPORAL LOBECTOMY - INFLUENCE OF SEIZURE CONTROL AND LEARNED HELPLESSNESS [J].
CHOVAZ, CJ ;
MCLACHLAN, RS ;
DERRY, PA ;
CUMMINGS, AL .
SEIZURE, 1994, 3 (03) :171-176
[8]  
CRAMER JA, 1994, NEUROL CLIN, V12, P1
[9]  
Dasheiff R M, 1994, Seizure, V3, P197, DOI 10.1016/S1059-1311(05)80189-X
[10]   LEARNED RESOURCEFULNESS AND PSYCHOSOCIAL ADJUSTMENT FOLLOWING TEMPORAL LOBECTOMY IN EPILEPSY [J].
DERRY, PA ;
CHOVAZ, CJ ;
MCLACHLAN, RS ;
CUMMINGS, A .
JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY, 1993, 12 (04) :454-470