Evaluation of quality of life and clinical status of children operated on for intractable epilepsy.
OBJECTIVE
The aim of the study was evaluation of surgical treatment of epilepsy measured by changes in quality of life (QOL) and in seizure frequency and severity.


METHODS
Examined group consists of 24 boys and 9 girls. We performed corpus callosotomy, lesionectomy, vagal nerve stimulation, temporal lobectomy and multiple subpial transections. Age at surgery ranged from 5 months to 19 years, with mean follow-up of 11.9 months. QOL was evaluated on the basis of the questionnaire created by us, in which parents were asked to assess the following variables before and after the surgical procedure: communication, socialization, daily living skills, movement abilities and behavioural problems. The seizure frequency was assessed with the Engel's scale, the modified Engel's scale and the Seizure Scoring System. Clinical state of all the patients was evaluated as well.


RESULTS
There were no patients with stable and worsening QOL status. In the whole group treated with callosotomy, the considerable improvement in QOL concerned 36.4% of cases. In more than 95% of cases, the reduction in seizures frequency is greater than 75%. In more than 43% of patients, there are no seizures after surgery.


CONCLUSIONS
Surgical treatment of intractable epilepsy is an effective method in terms of both seizure control and QOL improvement. Our results indicate the improvement in QOL of all operated patients. The improvement in QOL was accompanied by decrease in frequency and 'positive' changes in morphology of seizures. Improvement in QOL, as equivalent to seizure reduction rate, may influence further differentiation of qualification methods and surgical procedures of epilepsy.
Larysz
Dawid
D
Department of Pediatric Neurosurgery, Medical University of Silesia, ul. Medykow 16, 40-752, Katowice, Poland. dawilar@poczta.onet.pl
Larysz
Patrycja
P
Mandera
Marek
M
D000293:Adolescent; D001921:Brain / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000150:complications / Q000523:psychology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019635:Neurosurgical Procedures; D011788:Quality of Life; D012640:Seizures / Q000209:etiology / Q000517:prevention & control; D011795:Surveys and Questionnaires