Abstracts

Rationale: Studies on outcome of epilepsy surgery done in the last years have failed to show significant effects on employment (Chin et. al. 2006). The study evaluates the effects of a special rehabilitation program for patients undergoing temporal lobe resection (TLR). Methods: In the epilepsy centre Bethel in 1997 a short term rehabilitation unit was launched and a special program for patients undergoing surgical treatment developed. It includes full medical treatment, neuropsychology, psychotherapy and psychiatric interventions, sport, occupational therapy and thorough counselling concerning social and vocational issues. 103 consecutive patients >16 years old getting TLR before the launch of the reha unit (7/1991-3/1996; NoR group) were compared with 167 patients operated 2/1998 - 5/2002 (R group), using medical, neuropsychological, psychiatric and social data. Definitions: Unemployed - unemployed, on disability pension, in sheltered employment; employed - employed or in long term vocational training. Results: There were no significant differences between the two groups in relation to unemployment rates before surgery (34% NoR group, 35% R group), seizure outcome, side of surgery, gender, IQ, personality and psychiatric disturbances. R patients were significantly older. Two years after surgery, 75% of the R group were employed, compared to 61% of the NoR patients (p = .01). Logistic regression analysis in the NoR group indicated personality disorders, seizure outcome and employment situation preoperatively as predictors for employment two years after TLR, in contrast to the R group where only employment situation preop was kept as a predictor. Conclusions: A rehabilitation program tailored to the needs of patients with epilepsy obviously improves employment two years after TLR. Effective factors seem to be: a) medical, psychiatric, psychological and social work support aiming at successful work integration immediately after surgery b) second intake of patients who are not yet integrated into work or enrolled in a vocational rehabilitation program six months after surgery. References: Chin, P., A. Berg, et al. Neurology 66 June (2 of 2) 2006