title: Health-related quality of life over time since resective epilepsy surgery.
abstract: OBJECTIVE
  Health-related quality of life (HRQOL) improves after resective epilepsy surgery, but data are limited to short follow-up in mostly retrospective reports, with minimal consideration of other potential factors that might influence HRQOL.
  
  
  METHODS
  In a prospective multicenter study, 396 patients underwent resective epilepsy surgery. They completed the Quality of Life in Epilepsy Inventory-89 (QOLIE-89) before surgery, within 6 months, and at approximately yearly intervals after surgery. Seizure outcome was ascertained by phone calls every 3 months, and dates of postoperative seizures were chronicled. Overall HRQOL as measured by the QOLIE-89 was evaluated with respect to seizure outcome using logistic regression.
  
  
  RESULTS
  QOLIE-89 scores increased significantly at the first postoperative measurement (within 6 months after surgery) in the cohort overall; subsequent changes over time were sensitive to seizure-free and aura-free status. After adjusting for baseline scores, the corresponding postsurgical QOLIE-89 overall, and four dimension scores, increased as a function of square root of time seizure-free, and independently as a function of square root of time aura free, leveling by 2 years of stable seizure (aura) status. HRQOL was not independently related to duration of epilepsy, duration of intractable epilepsy, or continuation of medications.
  
  
  CONCLUSIONS
  HRQOL improves early after surgery, regardless of seizure outcome. Subsequent changes parallel length of time seizure free or aura free, stabilize after 2 years, and are unrelated to duration of epilepsy, duration of intractable epilepsy, or continued medication use.
authors.affiliation: Department of Neurology, Yale University School of Medicine, New Haven, CT 06520-8018, USA. susan.spencer@yale.edu
authors.forename: Susan S
authors.initials: SS
authors.lastname: Spencer
authors.forename: Anne T
authors.initials: AT
authors.lastname: Berg
authors.forename: Barbara G
authors.initials: BG
authors.lastname: Vickrey
authors.forename: Michael R
authors.initials: MR
authors.lastname: Sperling
authors.forename: Carl W
authors.initials: CW
authors.lastname: Bazil
authors.forename: Sheryl
authors.initials: S
authors.lastname: Haut
authors.forename: John T
authors.initials: JT
authors.lastname: Langfitt
authors.forename: Thaddeus S
authors.initials: TS
authors.lastname: Walczak
authors.forename: Orrin
authors.initials: O
authors.lastname: Devinsky
mesh_terms: D000328:Adult; D000368:Aged; D004827:Epilepsy / Q000453:epidemiology* / Q000523:psychology / Q000601:surgery*; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000523:psychology / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D015995:Prevalence; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology