Psychological adjustment to success and to failure following epilepsy surgery

Treatment-refractory epilepsy can directly impair psychological adjustment and quality of life. Epilepsy surgery is viewed by the patient as a stressf ul life event, arrived at after extensive deliberation. It is accompanied b y expectations and anxiety for patients and their families. We suggest that the success of epilepsy surgery (as reflected by patient-perceived impact on quality of life) depends not only on reduced seizure frequency, but on p ersonality factors and psychosocial issues. This paper reviews our research on these factors, along with suggestions for psychological assessment (of quality of life, and of personality) and psychological treatment. Studies o f quality of life in patients undergoing temporal lobectomy are also examin ed. Finally, factors leading to the perception of "failed" epilepsy surgery are considered, along with suggested ways to manage such cases.