Abstracts

Since the 90[rsquo]s there has been increasing scientific interest in the conceptualization and measurement of quality of life among patients with epilepsy, especially features regarding psycho-social aspects. Despite the known neuropsychological deficits observed in these patients, its relation with quality of life remains unclear. Considering that the surgical treatment of epilepsy enables control, or even complete remission of seizures, we believe that it should also affect social abilities in some way. This study aimed to analyze social adjustment and its correlation with neuropsychological function in patients with epilepsy submitted to temporal lobectomy and seizure-free for at least one year.
Our series was made up by 16 patients (50% male, aged from 18 to 54y [mean 36y]) submitted to temporal lobectomy (62.5% left) and seizure-free for 1 to 7 years (mean 2.06 y). The Social Adjustment Scale-Self-Report (SAS) was applied on these patients. This scale consists of 54 questions that evaluate performance, quality of personal interrelationship, and personal satisfaction. It comprises seven specifics areas: employment status; social and recreational activities; relationship with extended family members; role as a family member; marital role; parental role; and economic independence. We also evaluated patients for learning and memory skills, using verbal and visual stimuli (Rey Auditory Verbal Learning Test - RAVLT and Rey Visual Design Learning Test - RVDLT), and mental flexibility (Wisconsin Card Sorting Test - WCST). All results were compared with normative data.
Patients had low scores on all SAS sub-factors (p[lt]0.001). The sub-factor employment status showed significant correlation with delayed recall of verbal and visual stimuli (p 0.03) and with the number of categories achieved on WCST. Results were not influenced by other variables such as age, gender and foci lateralization as well as by seizure control, since all patients were seizure-free.
Our findings suggest that the level of social adjustment remains impaired even when total seizure control, the main goal of epilepsy surgery, is achieved. However, we noted that our patients with higher scores for memory and mental flexibility presented better employment status. We believe our findings emphasize the need and importance of a neuropsychological rehabilitation program, as part of epilepsy surgery programs, and as a complementary pot-surgical treatment aiming to provide improvement of cognitive and social skills.