Neuroscience
von Lehe M, Lutz M, Kral T, Schramm J, Elger CE, & Clusmann H. Correlation of health-related quality of life after surgery for mesial temporal lobe epilepsy with two seizure outcome scales. Epilepsy and Behavior 2006 Aug; 9(1): 73-82.
Department of Neurosurgery, University Clinic Bonn, Bonn, Germany.
PURPOSE: The objective of this study was to correlate health-related quality of life (HRQOL) after surgery for mesial temporal lobe epilepsy, as revealed by a postoperative screening tool, to different modalities of seizure outcome classification (Engel, International League Against Epilepsy (ILAE)). METHOD: One hundred twenty-eight of one hundred forty consecutive patients returned a HRQOL questionnaire at a mean of 36 months after selective amygdalohippocampectomy. Patients answered in two ways: with an absolute estimation (values 1-4) and with a self-rated relative change (-1, 0, +1) after surgery. RESULTS: Eighty patients were seizure- and aura-free (63.3% ILAE 1), 16 continued to have auras (12.5% ILAE 2), and 13 experienced 1-3 seizure days per year after surgery (10.2% ILAE 3). Ninety-two patients were classified seizure-free (71.9% Engel I), and 17 had two or fewer seizures per year (13.3% Engel II). Of 110 patients in ILAE 1-3, 100 (91%) stated good or even very good postoperative HRQOL, and 99 (90.0%) reported improvements in HRQOL. Only 9 of the remaining 18 (50%) reported good or very good HRQOL after surgery (P=0.01). Corresponding results were obtained with Engel classes I and II, suggesting a trend toward ILAE 1-3 and Engel I and II as overall satisfactory outcomes. A more detailed HRQOL assessment yielded lowest scores in the cognitive domain, and a significant correlation of self-rated changes in cognitive functioning with seizure control (P=0.01). Changes in physical capabilities and mood were significantly better with satisfactory seizure outcome (P=0.006 and P<0.001, respectively), whereas the social aspects were not significantly dependent on seizure outcome (P=0.06). CONCLUSION: Correlation of HRQOL and seizure control suggested that ILAE 1-3 and Engel I and II most likely represent overall satisfactory outcome. Subdomain analyses revealed cognitive abilities as the most critical feature associated with seizure control, whereas social aspects remained mainly stable.
PMID: 16730476 [PubMed - indexed for MEDLINE]
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Anthony H. Risser | neuroscience | neuropsychology | brain
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- Event: Tokyo, 29 April - 01 May 2005
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- Abstract Of The Day: Pediatric Epilepsy
Fastenau PS, Shen J, Dunn DW, Perkins SM, Hermann BP, Austin JK. Neuropsychological predictors of academic underachievement in pediatric epilepsy: Moderating roles of demographic, seizure, and psychosocial variables. Epilepsia. 2004 Oct; 45(10): 1261-72. ...
Neuroscience
Abstract of the Day: Quality of Life (QOL) Measurement in Epilepsy
von Lehe M, Lutz M, Kral T, Schramm J, Elger CE, & Clusmann H. Correlation of health-related quality of life after surgery for mesial temporal lobe epilepsy with two seizure outcome scales. Epilepsy and Behavior 2006 Aug; 9(1): 73-82.
Department of Neurosurgery, University Clinic Bonn, Bonn, Germany.
PURPOSE: The objective of this study was to correlate health-related quality of life (HRQOL) after surgery for mesial temporal lobe epilepsy, as revealed by a postoperative screening tool, to different modalities of seizure outcome classification (Engel, International League Against Epilepsy (ILAE)). METHOD: One hundred twenty-eight of one hundred forty consecutive patients returned a HRQOL questionnaire at a mean of 36 months after selective amygdalohippocampectomy. Patients answered in two ways: with an absolute estimation (values 1-4) and with a self-rated relative change (-1, 0, +1) after surgery. RESULTS: Eighty patients were seizure- and aura-free (63.3% ILAE 1), 16 continued to have auras (12.5% ILAE 2), and 13 experienced 1-3 seizure days per year after surgery (10.2% ILAE 3). Ninety-two patients were classified seizure-free (71.9% Engel I), and 17 had two or fewer seizures per year (13.3% Engel II). Of 110 patients in ILAE 1-3, 100 (91%) stated good or even very good postoperative HRQOL, and 99 (90.0%) reported improvements in HRQOL. Only 9 of the remaining 18 (50%) reported good or very good HRQOL after surgery (P=0.01). Corresponding results were obtained with Engel classes I and II, suggesting a trend toward ILAE 1-3 and Engel I and II as overall satisfactory outcomes. A more detailed HRQOL assessment yielded lowest scores in the cognitive domain, and a significant correlation of self-rated changes in cognitive functioning with seizure control (P=0.01). Changes in physical capabilities and mood were significantly better with satisfactory seizure outcome (P=0.006 and P<0.001, respectively), whereas the social aspects were not significantly dependent on seizure outcome (P=0.06). CONCLUSION: Correlation of HRQOL and seizure control suggested that ILAE 1-3 and Engel I and II most likely represent overall satisfactory outcome. Subdomain analyses revealed cognitive abilities as the most critical feature associated with seizure control, whereas social aspects remained mainly stable.
PMID: 16730476 [PubMed - indexed for MEDLINE]
-
Anthony H. Risser | neuroscience | neuropsychology | brain
- Investigating The 'dreamy State'
Patients with temporal lobe epilepsy sometimes experience unusual hallucinations and strange sensations when they have a seizure. Back in the nineteenth century, the legendary English neurologist John Hughlings Jackson called these experiences ‘dreamy...
- Depression Linked With Increased Risk Of Epilepsy
People who have suffered from serious depression or who have attempted suicide could be at increased risk of developing epilepsy. That’s according to a team of American and Icelandic researchers who said more work was needed to explain the link, which...
- Psychogenic Nonepileptic Seizures
The 01 September 2005 issue of the journal American Family Physician has an overview directed toward general practitioners, internists, and family-practice docs on the topic of psychogenic nonepileptic seizures, explaining what they are, how they can...
- Event: Tokyo, 29 April - 01 May 2005
An International Symposium on "Epileptic Syndromes in Infancy and Early Childhood—Evidence-based Taxonomy and Its Implications in the ILAE Classification," will be held at Tokyo Women’s Medical University Campus, Tokyo, Japan. The meeting will take...
- Abstract Of The Day: Pediatric Epilepsy
Fastenau PS, Shen J, Dunn DW, Perkins SM, Hermann BP, Austin JK. Neuropsychological predictors of academic underachievement in pediatric epilepsy: Moderating roles of demographic, seizure, and psychosocial variables. Epilepsia. 2004 Oct; 45(10): 1261-72. ...