HEALTH-RELATED QUALITY-OF-LIFE AND SEIZURE CONTROL IN TEMPORAL-LOBE EPILEPSY

We conducted a prospective study over 24 months to compare health-rela ted quality of life in surgically and medically treated patients with intractable temporal lobe epilepsy. Seizure frequency and health-relat ed quality of life were assessed in 81 patients before and 6, 12, and 24 months after treatment. Using the Epilepsy Surgery Inventory 55 (ES I-55), we compared (1) different seizure outcome groups and (2) tempor al lobectomy with continuing medical management. Follow-up was satisfa ctory in 72 patients (89%), 51 treated with temporal lobectomy and 21 with no surgery. Pretreatment seizures and health-related quality of l ife were comparable in the two groups. Seizure outcome was significant ly better at 6, 12, and 24 months after surgery. At 24 months, seizure -free patients and those with at least a 90% reduction in seizure freq uency reported significant improvements in health-related quality of l ife (on 5 of 10 subscales and overall Epilepsy Surgery Inventory 55 sc ale). Deterioration in quality of life occurred with less than 90% sei zure reduction. Only one Epilepsy Surgery Inventory 55 subscale at 6 m onths and two subscales at 12 months showed a significant difference. Patients with good seizure outcome experience improved health-related quality of life after treatment. Since temporal lobectomy results in c onsiderably better seizure control than continued medical management, the findings support surgery as the preferred treatment, although chan ges in health-related quality of life may not be evident until the sec ond postoperative year.