Factors associated with work outcome after anterior temporal lobectomy for intractable epilepsy.
OBJECTIVE
Whereas the effect of anterior temporal lobectomy on seizure frequency is well recognized, less is known about its impact on work status.


METHODS
One hundred thirty-four of 190 consecutive patients with temporal lobectomy participated in this study. Eligibility criteria were developed to ensure that only patients with the potential of achieving specific outcomes were included in the corresponding analyses.


RESULTS
After surgery, significantly more patients were independent in activities of daily living (p < 0.001) or able to drive (p < 0.001). Income from work also increased (p < 0.01). Nearly one fifth of the patients who were eligible for analysis had either a gain (8%) or a loss (11%) of full- or of part-time work. Univariate analyses revealed the following factors to be associated with full-time work after surgery: student or full-time work within a year before surgery, full-time work experience before surgery, full- or part-time employment experience before surgery, no disability benefits before surgery, low postsurgical seizure frequency, improved postsurgical seizure control, excellent postsurgical seizure control, driving after surgery, and further education after surgery (p < 0.05). Significant factors on multivariate analysis were being a student or having full-time work within a year before surgery [odds ratio, 16.2 (95% CI, 4.3-60.5)], driving after surgery [15.2 (3.2-72.0)], and obtaining further education after surgery [9.2 (2.2-53.0)].


CONCLUSIONS
Anterior temporal lobectomy for intractable epilepsy improves activities of daily living and the ability to drive. Work outcome of this surgery is influenced by presurgical work experience, successful postsurgical seizure control especially to allow driving, and obtaining further education after surgery.
Reeves
A L
AL
Department of Neurology, Mayo Clinic, Rochester, Minnesota 55905, USA.
So
E L
EL
Evans
R W
RW
Cascino
G D
GD
Sharbrough
F W
FW
O'Brien
P C
PC
Trenerry
M R
MR
D000203:Activities of Daily Living; D000328:Adult; D000704:Analysis of Variance; D001334:Automobile Driving; D004651:Employment; D017029:Epilepsy, Complex Partial / Q000534:rehabilitation / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007182:Income; D008297:Male; D015999:Multivariate Analysis; D013702:Temporal Lobe / Q000601:surgery*; D016896:Treatment Outcome; D014937:Work / Q000706:statistics & numerical data*