Changes in the quality of life of children after surgical treatment for drug-resistant temporal lobe epilepsy

Abstract

Objective: to evaluate the impact of surgical treatment for drug-resistant temporal lobe epilepsy in children on seizure frequency and quality of life.Patients and methods. Examinations were made in 80 children aged 2–17 years with drug-resistant temporal lobe epilepsy, who had undergone surgery in 2011–2016. To assess its outcomes, the investigators used the Quality of Life Childhood Epilepsy, QOLCE questionnaire for patients' parents and the Engel Epilepsy Surgery Outcomes Scale.Results and discussion. In the long-term period after surgical treatment, 54.5% of the children with drug-resistant temporal lobe epilepsy achieved a favorable outcome (Engel class I); there were significant (p<0.05) positive changes in quality of life subdomains, such as speech, physical limitations, energy levels/weakness, and overall quality of life. Comparison of quality of life before and after surgical treatment established its positive impact on subdomains, such as social contacts and activity, behavior, physical limitations, attentiveness, memory, and speech. In general, there was a neutral or beneficial effect of the treatment on most of the quality of life subdomains.Conclusion. To make recommendations based on high-level evidence, there is a need for further multicenter prospective studies of large patient populations with a detailed analysis of the relationship of factors influencing the outcome of surgery and indicators of psychosocial well-being of a child. The preoperative and postoperative changes in health and quality of life indicators cannot be more accurately assessed in patients without standardizing their preoperative examination algorithm and using equivalent psychometric tools.

Keywords

• children
• temporal lobe epilepsy
• epilepsy
• epilepsy surgery
• quality of life