Abstracts

Rationale: Previous study of our underserved Hispanic patient population with intractable epilepsy showed high instances of co-morbid depression and anxiety during their comprehensive, pre-surgical evaluation. We later demonstrated that 1-year post-surgery their quality of life (QOL) improved. We hypothesized that epilepsy surgery would also improve these patients’ depressive and anxiety symptoms.Methods: Adult Hispanic patients’ (n = 31; males = 51.6%) pre- and 1-year post-surgery Beck Depresion Inventory-II (BDI-II), Beck Anxiety Inventory (BAI) and QOLIE-31 v2 inventories were retrospectively analyzed. Participants were from a public healthcare, comprehensive epilepsy treatment center in Los Angeles, CA. Patients were primarily immigrant (93.5%), with 80.6% tested in Spanish. Mean age at pre-surgical evaluation was 35.3 ± 10.3 years. Seizures arose from the temporal lobe in 93.5% and left hemisphere in 51.6%. Surgeries included standard temporal lobectomy (67.7%), selective amygdalohippocampectomy (19.4%), lateral temporal resection (6.5%) and extra-temporal lesionectomy (6.5%). One-tailed, paired t-tests were used to compare patients’ pre- and post-surgical scores.Results: One-year, post-operative Engel Class I was achieved in 83.9% of patients. Mean pre-surgical BDI-II score was 14.8, in the “mild” range for depression, whereas the mean post-surgical BDI-II score improved to 7.1, the “minimal” range, which was significant, p<0.001. Mean pre-surgical BAI score was 13.4, “mild,” which improved post-operatively to 6.5, “minimal,” p<0.01. All QOLIE-31 v2 scales improved. Select subscales were statistically significant, i.e., Total QOLIE (p<0.001), Seizure Worry (p<0.001), Medication Effects (p=0.009), Social Function (p=0.003), Distress (p=0.01), and Overall QOL (p=0.002). Remaining subscales approached significance, i.e., Emotional Well-Being (p=0.08), Energy/Fatigue (p=0.08) and Cognitive (p=0.06). QOL results are generally consistent with our previous investigation, save that Energy/Fatigue did not significantly improve in this analysis. BDI-II, BAI and QOLIE-31 scores did not significantly differ by gender or surgical lateralization.Conclusions: Surgical treatment for intractable epilepsy reduced seizure burden and significantly improved symptoms of depression, anxiety and quality of life in a primarily immigrant, underserved, Hispanic population. Our results are encouraging and add to the growing body of literature on positive surgical outcomes in Hispanics. These data may also be useful in the education of this population about the specific benefits of surgical intervention for medically refractory epilepsy.