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Quality of Life and Psychosocial Outcomes in Children Following Epilepsy Surgery

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Long-Term Outcomes of Epilepsy Surgery in Adults and Children

Abstract

Quality of life (QOL) and psychosocial functioning of children diminishes with the onset of seizures. The adult outcomes of patients show some improvements with good seizure control but impairments in some areas remain. Epilepsy surgery in childhood has the potential to eliminate seizures, which may lead to improvements in QOL and psychosocial functioning. This chapter reviews recent work on the long-term QOL and psychosocial outcomes following epilepsy surgery in childhood. The few studies that have examined these outcomes find overall improvements in QOL, but are not always concordant as to which QOL domains show improvements. Similarly, although improvements are found in overall psychosocial functioning, there is no consensus on which domains improve. Improvements in QOL and psychosocial functioning, when evident, are consistently associated with seizure freedom. More recently, mood and affective symptoms have been found to be integral in ratings of QOL. Further work is needed to identify specific affective symptoms that lead to diminished QOL and psychosocial functioning and to identify other variables that may be involved, such as IQ or memory, and family function.

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Author information

Authors and Affiliations

  1. Department of Psychology, The University of Toronto, Toronto, ON, Canada

    Mary Lou Smith PhD

  2. Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, ON, Canada

    Mary Lou Smith PhD

  3. Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada

    Mary Lou Smith PhD & Klajdi Puka HBSc

Authors
  1. Mary Lou Smith PhD
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  2. Klajdi Puka HBSc
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Corresponding author

Correspondence to Mary Lou Smith PhD .

Editor information

Editors and Affiliations

  1. Sahlgrenska University Hospital and Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden

    Kristina Malmgren

  2. Department of Clinical and Experimental Epilepsy, National Hospital for Neurology and Neurosurgery, London, United Kingdom

    Sallie Baxendale

  3. UCL-Institute of Child Health, Great Ormond Street Hospital for Children, London and Young Epilepsy, Lingfield, Surrey, United Kingdom

    J. Helen Cross

Appendix. Summary of Long-Term (≥2 years) Studies of Quality of Life and Psychosocial Outcomes in Children After Epilepsy Surgery

Appendix. Summary of Long-Term (≥2 years) Studies of Quality of Life and Psychosocial Outcomes in Children After Epilepsy Surgery

Author, year

Study design

Participants† (children) N

Surgical N

Males

Age (yr) at surgery (min-max)

% life (yr) with epilepsy

Prognostic indicators studied

Intervention

Seizure outcome measure

Seizure-free N

Follow-up (min-max/years)

Keene et al. [33]

CS

64 (20)

64

39

12.2 (4.8)**

NS

a,b

T-EXT

B

35

7.6 (3.8)** 2 - NS

Keene et al. [54]

CS

64 (20)

64

39

12.2 (4.8)**

NS

a

T-EXT

E

35

7.6 (3.8)** 2 - NS

Lach et al. [38]

CS

102 (0)

71

41

13.5 (3.71)**

0.5–18.4

67(23)**

a,c,e,g,l

T-EXT

A

38‡

8.8 (4.9)**

2–22

Elliot et al.[35]

CS

98 (0)

69

37

13.5 (3.71)**

0.5–18.4

66(24)**

a,c,d,f,h,i,j,m

T-EXT

A

38‡

8.8 (4.9)**

2–22

Puka and Smith [37]

CS

109 (34)

71

68

13.2 (4.3)**

4.25–18.83

58(28)**

a,d,j,k,n

T-EXT

A

Surgical: 40

Controls: 16

6.9 (2.2)**

4–11

  1. CS cross-sectional, NS not specified, T temporal, EXT extratemporal, A seizure free > 1 year, B seizure free > 2 years, E Engel classification, a seizure status, b type of surgical procedure (temporal resection, extratemporal resection, or hemispherectomy), c age of seizure onset, d years since surgery/follow-up, e proportion of life with epilepsy, f duration of epilepsy, g age at surgery, h current age, i sex, j AED use, k IQ, l emotional well-being, m mood state, n affective symptoms, yr years, † All patients were children at baseline or time of surgery-number in parentheses refers to those aged 18 years or less at time of follow-up, ‡ Inclusion criteria for nonsurgical group was active epilepsy, ** Mean (SD)

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Smith, M.L., Puka, K. (2015). Quality of Life and Psychosocial Outcomes in Children Following Epilepsy Surgery. In: Malmgren, K., Baxendale, S., Cross, J. (eds) Long-Term Outcomes of Epilepsy Surgery in Adults and Children. Springer, Cham. https://doi.org/10.1007/978-3-319-17783-0_13

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  • DOI: https://doi.org/10.1007/978-3-319-17783-0_13

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-17782-3

  • Online ISBN: 978-3-319-17783-0

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