Health-related quality of life using QOLIE-31: before and after epilepsy surgery a prospective study at a tertiary care center.
BACKGROUND
Outcome following epilepsy surgery has traditionally been measured in terms of relief of seizures. However, changes in health-related quality of life (HRQOL) after surgery for intractable epilepsy are also important to document. There are no studies on the Indian population which assess the outcome of epilepsy surgery in terms of HRQOL.


METHODS
We conducted a prospective study on the patients undergoing epilepsy surgery for intractable seizures, between February 2004 and May 2006 at our center. All patients cleared for epilepsy surgery by the epilepsy surgery team were taken up for study. All patients


RESULTS
Thirty-six patients satisfying the inclusion/exclusion criteria were included in the analysis. Twenty-nine of these (Group 1) had good seizure outcome (Engel 1 and 2), while seven patients (Group 2) had poor seizure outcome (Engel 3 and 4) at six months. Overall, 77% of all study patients were completely seizure-free at follow-up. There was no baseline difference in the seven domains of QOLIE-31 between the two groups. There was very significant improvement (P value>0.005 using paired sample T test) in all the domains of QOLIE-31 in the good outcome group after surgery. Health-related quality of life improvement was seen in all the domains in the poor outcome group also, however, it was statistically significant only for the following parameters: seizure worry, overall QOL, emotional wellbeing, energy fatigue and social functioning domains. Improvement in seizure worry, overall QOL, emotional wellbeing and social functioning was significantly more in Group 1 as compared to Group 2.


CONCLUSIONS
Complete seizure-free state after surgery is associated with very significant improvement in HRQOL parameters. Several, but not all parameters of HRQOL as assessed by QOLIE-31, improved after surgery even in the poor seizure outcome group. The improvement in domains of seizure worry, overall QOL, emotional wellbeing and social functioning is significantly more in those patients in whom complete seizure-free state is achieved.
Department of Neurosurgery, Neurosciences Center, All India Institute of Medical Sciences, New Delhi-110 029, India.
Faiz Uddin
FU
Ahmad
Manjari
M
Tripathi
M V
MV
Padma
Shailesh
S
Gaikwad
Aditya
A
Gupta
C S
CS
Bal
Chitra
C
Sarkar
Surya
S
Gupta
Ashima N
AN
Wadhawan
Bhavani S
BS
Sharma
Poodipedi Sarat
PS
Chandra
D000293:Adolescent; D000328:Adult; D004827:Epilepsy / Q000473:pathology / Q000523:psychology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures; D011446:Prospective Studies; D011788:Quality of Life; D012640:Seizures / Q000523:psychology / Q000601:surgery; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult