title: Health-related quality of life and self-perceived competence of children assessed before and up to two years after epilepsy surgery.
abstract: OBJECTIVE
  To measure outcome of epilepsy surgery in terms of health-related quality of life (HrQoL) and self-perceived competence of children and adolescents.
  
  
  METHODS
  Prospective longitudinal follow-up study of 21 patients (aged 6.2 to 16.8 years). Frequency and severity of seizures and epilepsy-related restrictions, HrQoL, and self-perceived competence were rated before and 6, 12, and 24 months after epilepsy surgery. Data were analysed nonparametrically and using analysis of variance for repeated measures.
  
  
  RESULTS
  Group-wise, seizure parameters had almost normalized 6 months after surgery (p<0.001) and remained so. Two years after surgery, 15 (72%) patients were free of seizures. At the first postsurgical assessment, parents and children evaluated the frequency of activities as improved and that of seizures as diminished (p<0.05). Parents evaluated their children as having positive emotions more frequently (p<0.05). Children started to feel better about seizure variables in the second year after surgery. Two years after surgery, children perceived themselves as being socially more competent and having greater self-worth (p=0.05). In the adolescent group, several aspects of self-perceived competence improved shortly after surgery (p<0.05), whereas 2 years after surgery, athletic competence and romance had improved (p<0.05).
  
  
  CONCLUSIONS
  In children and adolescents, epilepsy surgery sets the stage for improvement in HrQoL and in competence to participate in social and societal domains. Most improvement occurs in the first 6 months after surgery.
authors.affiliation: Department of Pediatric Physical Therapy and Exercise Physiology, University Medical Center-Wilhelmina Children's Hospital, Utrecht, The Netherlands. R.vanEmpelen@wkz.azu.nl
authors.forename: Ron
authors.initials: R
authors.lastname: van Empelen
authors.forename: Aag
authors.initials: A
authors.lastname: Jennekens-Schinkel
authors.forename: Peter C
authors.initials: PC
authors.lastname: van Rijen
authors.forename: Paul J M
authors.initials: PJ
authors.lastname: Helders
authors.forename: Onno
authors.initials: O
authors.lastname: van Nieuwenhuizen
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001294:Attitude to Health; D002540:Cerebral Cortex / Q000601:surgery; D002648:Child; D004827:Epilepsy / Q000175:diagnosis* / Q000523:psychology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality / Q000502:physiology; D006304:Health Status; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology; D010555:Personality Inventory; D011184:Postoperative Period; D011788:Quality of Life; D020377:Self Efficacy; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D012917:Social Adjustment; D011795:Surveys and Questionnaires; D016896:Treatment Outcome