Abstracts

Although the clinical goal of resective epilepsy surgery is seizure freedom, patients may have a wide set of expectations for this invasive procedure. This study[apos]s goals were to assess the nature, range, and frequency of preoperative expectations for resective epilepsy surgery, and to explore whether expectations vary across patient sociodemographic and clinical characteristics., 396 adults and adolescents with refractory epilepsy were enrolled in a seven-center cohort study and underwent resective surgery. During baseline interviews, patients responded to open-ended questions about expectations for surgery. Investigators reviewed text responses and identified a preliminary set of expectation themes. Each text response was placed on a card, then [quot]sorted[quot] into piles representing distinct themes (expectations) by consensus of three investigators. Differences in the frequencies for which each expectation theme was identified were explored across gender, ethnicity, education, whether temporal or extratemporal lobe epilepsy, and side of surgery, using chi-square., Among 391 respondents, nine unique expectations themes were identified by [gt]15% of the sample: driving (n=241, 61.6%); job/school (n=166, 42.5%); independence (n=115, 29.4%); seizure cessation (n=100, 25.6%); social functioning (n=90, 23.0%); quality of life (n=82, 21%); medication discontinuance (n=78, 20.0%); physical activities (n=71, 18.2%); and cognition (n=67, 17.1%). Non-whites and whites differed on 3 of 9 expectation themes: non-whites (n=72, 18% of sample) endorsed job/school and cognition more frequently and driving less frequently than did whites (p[lt]0.03). Respondents with a higher level of education (n=95, 24% of sample with bachelor[apos]s degree or higher) endorsed cognition more frequently than those with less education (p[lt] 0.003). Subjects with a right-sided resection (n=190, 49% of sample) endorsed social functioning more frequently than those with a left-sided resection (p[lt]0.05). There were no differences in expectations by gender or temporal versus extratemporal lobe epilepsy., Patients awaiting resective epilepsy surgery have definable expectations for surgery, the most predominant of which are driving and employment/educational attainment. While the majority of these expectations were similar across a range of patient characteristics, there were differences on one-third of the most frequently reported expectations by ethnicity. Future studies are needed to explore these potential sociodemographic differences, and to understand how expectations may aide in the clinical decision-making process of resective epilepsy surgery., (Supported by Grant #RO1 NS 32375 from the National Institute of Neurological Disorders and Stroke.)