title: Prospective and longitudinal long-term employment outcomes after resective epilepsy surgery.
abstract: OBJECTIVE
  To investigate long-term employment outcomes after resective epilepsy surgery in a national population-based cohort of adults.
  
  
  METHODS
  In the Swedish National Epilepsy Surgery Register, all adults who were operated with resective epilepsy surgery from 1995 to 2010 were identified. Two-year follow-up was available for 473/496, 5-year follow-up for 220/240, 10-year follow-up for 240/278, and 15-year follow-up for 85/109 patients.
  
  
  RESULTS
  There were no significant changes in employment outcome over time at group level, but for those with full-time employment at baseline, 79%, 79%, 57%, and 47% of seizure-free patients were in full-time work at 2-, 5-, 10-, and 15-year follow-up, compared to patients with benefits at baseline, where 16%, 27%, 31%, and 33% of seizure-free patients worked full time at these time points (p = 0.018 at 10 years). More patients with full-time work had ability to drive, a family of their own, and higher educational status than patients in part-time work or on benefits. Univariate predictors for employment at long term were having employment preoperatively, higher education, favorable seizure outcome, male sex, and younger age at surgery. Multivariate predictors were having employment preoperatively, favorable seizure outcome, and younger age.
  
  
  CONCLUSIONS
  The best vocational outcomes occurred in seizure-free patients who were employed or students at baseline, which may reflect a higher general psychosocial level of function. Younger age also predicted better employment outcomes and it therefore seems plausible that early referral for surgery could contribute to better vocational outcomes.
authors.affiliation: From the Department of Clinical Neuroscience and Rehabilitation (A.E., K.M.), Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg; and Department of Clinical Neurophysiology (R.F.), Uppsala University Hospital, Sweden. anna.edelvik@vgregion.se.
authors.forename: Anna
authors.initials: A
authors.lastname: Edelvik
authors.affiliation: From the Department of Clinical Neuroscience and Rehabilitation (A.E., K.M.), Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg; and Department of Clinical Neurophysiology (R.F.), Uppsala University Hospital, Sweden.
authors.forename: Roland
authors.initials: R
authors.lastname: Flink
authors.affiliation: From the Department of Clinical Neuroscience and Rehabilitation (A.E., K.M.), Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg; and Department of Clinical Neurophysiology (R.F.), Uppsala University Hospital, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Malmgren
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D038481:Anterior Temporal Lobectomy; D015331:Cohort Studies; D004522:Educational Status; D004651:Employment / Q000706:statistics & numerical data*; D004828:Epilepsies, Partial / Q000601:surgery; D004827:Epilepsy / Q000601:surgery*; D017034:Epilepsy, Frontal Lobe / Q000601:surgery; D004833:Epilepsy, Temporal Lobe / Q000601:surgery; D005260:Female; D005625:Frontal Lobe / Q000601:surgery; D038421:Hemispherectomy; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D009778:Occipital Lobe / Q000601:surgery; D010296:Parietal Lobe / Q000601:surgery; D011446:Prospective Studies; D012042:Registries; D012737:Sex Factors; D013548:Sweden; D013702:Temporal Lobe / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult