Quality of life self-assessment as a function of lateralization of lesion in candidates for epilepsy surgery

Purpose: This prospective study aimed to investigate the relationship(s) of the laterality of the epileptogenic lesion to personality factors, emotion al processing, and the subjective experience of quality-of-life (QOL) self- assessment in candidates for epilepsy surgery. Methods: Patients who were candidates for epilepsy surgery were studied. Ei ghteen of them (aged 19-61 years) had localization-related epilepsy in the right temporal lobe (RTLE), 18 (aged 21-50 years) had localization-related epilepsy in the left temporal robe (LTLE), and 20 were demographically matc hed normal subjects. The Spielberger Trait/State Anxiety questionnaire and the QOLIE-31 questionnaire for self-assessment of quality of lift: were use d. One-way analysis of variance, Pearson correlations, and linear regressio n analysts were performed on group and anxiety levels and QOLIE variables. Results: LTLE patients systematically showed higher levels of anxiety and l ower self-estimates of the quality of their lives when compared with RTLE p atients. All anxiety measures were highly correlated with Total QOL in LTLE (p < 0.05) but not in RTLE patients; however, different parameters of QOL showed different relationships with measures of anxiety. Results of multipl e regression analyses suggested that the level of anxiety was relatively st able and less affected by QOL factors in LTLE as compared with RTLE patient s (p = 0.03). Conclusions: A high level of anxiety shown by LTLE patients may represent a personality trait and cause a response bias in overreporting of negative s ymptoms and a decreased self-assessment of QOL. It may also present a presu rgical risk factor, particularly for patients with LTLE lesions. Appropriat e patient counseling is advised.