Outcome after Right Temporal Lobectomy (RTL): The Patients[ssquote] Perspective.
Abstract number :
2.304
Submission category :
Year :
2001
Submission ID :
2992
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
P.E. Penovich, MD, Minnesota Epilepsy Group, PA, St Paul, MN; B. Korby, RN, Minnesota Epilepsy Group, PA, St Paul, MN; J.R. Gates, MD, Minnesota Epilepsy Group, PA, St Paul, MN; G.L. Moriarty, MD, Minnesota Epilepsy Group, PA, St Paul, MN
RATIONALE: Patients who undergo epilepsy surgery begin the evaluation process and undergo the surgical procedure with expectations for seizure control and improved functional status. Patients being considered for nondominant right temporal lobectomy receive optimistic statistical information for improved seizure control. The impact on patients[ssquote] functional status and how surgery may change life experiences is often less clear.
METHODS: We surveyed patients post-operatively to evaluate their satisfaction with seizure control after RTL and to determine what life changes they experienced after the procedure. Questionnaires were mailed or personally given to patients who had had RTL. Questions addressed seizure control, medication status, work and school status, changes in psychosocial status, mood changes and whether the individual would [dsquote]do it again.[dsquote] Narrative comments were solicited for the [dsquote]best[dsquote] and the [dsquote]worst[dsquote] part of the experience.
RESULTS: Forty-five patients received questionnaires. Forty (88%) were returned. Ninety-five percent (43/45) were glad they had had surgery and 80% (34/45)[dsquote]would do it again[dsquote] without reservation. Seizure control was Engel Class I or II in 98%. Fifty-five percent were still on antiepileptic medications at follow-up of 0.5-8 years. Sixty percent were either in educational programs or were working. Overall psychosocial status had not changed in 58%. Of those who reported psychosocial changes, 64% (7/13)felt the change was positive. Only 6/45 reported a worsening of mood. Forty-two percent were on psychotropic medication. The narrative responses reflected experiences of pain, fear of what their individual results might be and [dsquote]waiting for seizures[dsquote] during pre-operative assessment. 2/45 spontaneously reported a decrease in sexual interest.
CONCLUSIONS: Overall, a majority of patients who had RTL achieve good to excellent seizure control, do well in vocational and social arenas, achieve personal goals and are pleased with the surgical outcome. They would go through the process again even if seizure control were not complete.
Support: None.