Abstracts

Previous research on quality of life following temporal lobectomy has had limited follow-up (generally under two years), and has grouped patients across multiple pathologies. This study aimed to examine long-term seizure and quality of life outcome in an homogenous group of patients following temporal lobectomy with pathologically proven hippocampal sclerosis (HS).
Fifty consecutive patients were identified as having had a temporal lobectomy for the treatment of temporal lobe epilepsy at Royal Melbourne Hospital with pathologically proven HS and at least two years follow-up. All patients were sent a postal survey concerning seizure activity, quality of life (QOLIE-89) and anti-epileptic drug (AED) use. The mean follow-up was 5.8 years (range 2-9.2).
The rate of complete post-operative seizure freedom was 82% at 12 months, 76% at 24 months, and 64% at 63 months (no further seizure recurrences observed after this time). A Class I seizure outcome was achieved in 84% of patients. Patients with better seizure outcome had significantly better quality of life (Kendall[apos]s tau = -234, p[lt].01). Of the 17 patients with seizure recurrence, five (29%) had their first recurrence 24 months or more following surgery. Seizure recurrence was associated with a reduction in AED intake or absorption in five patients, including three of the five patients with a first recurrence after 24 months following surgery.
Temporal lobectomy provides continued long-term seizure control in the majority of patients with HS. However, patients remain at risk of seizure recurrence two or more years after surgery. Long-term quality of life is dependent on seizure outcome.
[Supported by: Department of Human Services, Victoria, Australia]