Abstracts

The purpose of the surgical intervention for epilepsy treatment for medically refractory temporal lobe epilepsy is to render the patient seizure free with the clear implication that they can now drive, as well as continue or become productive members of society by being gainfully employed and living independently. This study was to obtain a long-term postoperative assessment of success in the areas of driving, employment, and independent living. This study involved patients who had received temporal lobectomies at the Minnesota Epilepsy Group between 1986 and 2001 and still actively being followed.
The study consisted of 44 patients, 21 males, 23 females, all of whom had received a temporal lobectomy between 1986 and 2001. Patients were sequentially selected who have met this fairly simple criteria of a limited temporal lobectomy of the right or left (X=Right, Y=Left) within that timeframe. Demographic seizures and medical data were retrospectfully collected from both groups. Patients were classified as being seizure free, which could include simple partial seizures, or having persistent complex partial or tonic-clonic seizures.
We documented the number of patients driving, living independently, and working before surgery and compared that to their seizure outcome and their conditions after the procedure. We concluded that the patients who worked and lived independently before surgery continued working and living independently. Those who did not work or live independently prior to surgery were able to achieve this state with a few exceptions described below. Prior to surgery, 13 patients were driving, after surgery 24 were driving. Of the remaining 20 patients, 5 were not driving due to seizure frequency, 8 due to cognitive impairment, 1 due to poor vision, 4 due to the expense or desire to drive, and 2 were unknown. 31 patients were working before surgery and 34 post surgery. Of the remaining 10 patients, only 2 were not working due to seizure activity, 1 due to memory impairment, 1 due to inability to handle pressure, 5 with mental impairment, and 1 unknown.
Temporal lobectomy does result in long-term improvement in independent living, gainful employment, and driving. These results appear to have been sustained for 3-17 years.