FACTORS ASSOCIATED WITH WORK OUTCOME AFTER ANTERIOR TEMPORAL LOBECTOMY FOR INTRACTABLE EPILEPSY

Purpose: Whereas the effect of anterior temporal lobectomy on seizure frequency is well recognized, less is known about its impact on work s tatus. Methods: One hundred thirty-four of 190 consecutive patients wi th temporal lobectomy participated in this study. Eligibility criteria were developed to ensure that only patients with the potential of ach ieving specific outcomes were included in the corresponding analyses. Results: After surgery, significantly more patients were independent i n activities of daily living (p < 0.001) or able to drive (p < 0.001). Income from work also increased (p < 0.01). Nearly one fifth of the p atients who were eligible for analysis had either a gain (8%) or a los s (11%) of full- or of part-time work. Univariate analyses revealed th e following factors to be associated with full-time work after surgery : student or full-time work within a year before surgery, full-time wo rk experience before surgery, full- or part-time employment experience before surgery, no disability benefits before surgery, low postsurgic al seizure frequency, improved postsurgical seizure control, excellent postsurgical seizure control, driving after surgery, and further educ ation after surgery (p < 0.05). Significant factors an multivariate an alysis were being a student or having full-time work within a year bef ore surgery [odds ratio, 16.2 (95% CI, 4.3-60.5)], driving after surge ry [15.2 (3.2-72.0)], and obtaining further education after surgery [9 .2 (2.2-53.0)]. Conclusions: Anterior temporal lobectomy for intractab le epilepsy improves activities of daily living and the ability to dri ve. Work outcome of this surgery is influenced by presurgical work exp erience, successful postsurgical seizure control especially to allow d riving, and obtaining further education after surgery.