Late Changes in Quality of Life in the Epilepsy Surgery Patient
Abstract number :
F.03
Submission category :
Year :
2000
Submission ID :
3195
Source :
www.aesnet.org
Presentation date :
12/2/2000 12:00:00 AM
Published date :
Dec 1, 2000, 06:00 AM
Authors :
Rebecca Rausch, Timothy O'Brien, Barbara Vickrey, UCLA Sch of Medicine, Los Angeles, CA.
RATIONALE: Patients who have medically intractable complex partial seizures who undergo left temporal lobe surgery for control of their epilepsy are at a greater risk for postoperative memory problems, particularly verbal memory deficits, than patients who undergo right temporal lobe surgery. The possible additional effect of further age-related decreases in memory functions on quality of life (QOL) in these surgical patients has rarely been addressed. METHODS: Patients who underwent temporal lobe surgery for their intractable seizures >10 years previously (Mean=17 yrs prior, range 10-25 yrs prior) and who were at least 40 years of age at the most recent evaluation (Mean =49 yrs of age, range 40-66 yrs) were included. Patients were assessed over the most recent 5 year interval. Dependent measure was change in Overall Quality of Life Score (QOLIE-89) over the most recent 5 year interval. Independent variables were change over the last 5 years in: two memory measures (Rey-Osterrieth Delayed Recall and WMS Logical Prose,Delayed Recall) and seizure occurrence. Surgery patients were stratified for side of surgery, either left temporal lobe surgery (N= 13) or right temporal lobe surgery (N=11). Multiple linear regression was used. RESULTS: In the left temporal lobe surgery group, a decrease in the Overall QOLIE-89 score was related to late decreases in both memory measures (Rey-Osterrieth, Delayed Recall, p<.01; Prose A,Delayed Recall, p<.006). Change in seizure occurrence was not uniquely related to change in Overall QOLIE-89 Score. Change in Overall QOLIE-89 score in the right temporal lobe surgery group was not related to either memory score changes or to change in seizure occurrence. CONCLUSIONS: The aging patient who previously underwent left temporal-lobe surgery for intractable epilepsy is more at risk for negative changes in QOL due to decreasing memory functions than patients who underwent right temporal lobe surgery. While the rate of change in memory functioning has been previously shown not to be greater in the left temporal lobe surgery patient, the lower base rate of memory plus age-related decline in memory relates to a late further decrease in QOL in these patients.