Abstracts

Evidence for the benefits of epilepsy surgery in children beyond seizure freedom is clearly lacking. The aim was to prospectively determine if epilepsy surgery is effective in improving the Quality of Life (QOL) of children with intractable seizures using the Quality of Life in Childhood Epilepsy Questionnaire (QOLCE). A prospective consecutive series of thirty-five children with intractable epilepsy, who underwent epilepsy surgery. Parents completed the QOLCE pre-operatively and again 6 to 18 months after surgery. At both assessment dates parents indicated the severity of their child[apos]s seizures during the last 6 months and the frequency of their child[apos]s seizures during the past 4 weeks on Likert-type scales. Children were split into two groups according to surgery outcome (seizure free versus persistent seizures). Statistical analyses were conducted to determine if children rendered seizure free showed a greater improvement in QOL compared to those with persistent seizures post-operatively. Mean age of seizure onset was 4.5 years. The mean age at surgery was 11.9 years. Focal resections were performed in 31, hemispherectomy in two and callosotomy in two. Seizure freedom post-operatively was obtained in 20/35 cases (57%). Greater improvement in QOL was documented for children rendered seizure free compared to children with persistent seizures. This was significant for the overall QOLCE QOL score (mean score seizure free = 73, persistent seizures =50 p=0.08) and subscales assessing cognitive, social, emotional, behavioural and physical domains of life. Stepwise multiple regression analysis showed that seizure outcome was the strongest predictor of change in QOL (B=0.51, p=0.002) followed by baseline level of QOL (B=0.44, p=0.005). Epilepsy surgery is able to improve the QOL of children rendered seizure free. Families can be counselled pre-operatively of the potential benefits of surgery beyond seizure reduction. (Supported by National Health and Medical Research Council of Australia.)