Life outcomes of anterior temporal lobectomy: serial long-term follow-up evaluations.
Life outcomes of anterior temporal lobectomy: serial long-term follow-up evaluations.
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DOI：
10.1227/neu.0000000000000145
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发表时间：
2013-12
期刊：
影响因子：
4.8
通讯作者：
Jackson DC
中科院分区：
文献类型：
--
作者：
Jones JE;Blocher JB;Jackson DC
这项研究在三个时间点检查了接受前颞叶切除术（ATL）的个体与接受药物治疗的颞叶癫痫个体的长期心理社会生活结果。参与者平均术后 17 年。每次随访评估均检查癫痫发作频率、就业、驾驶、独立生活、经济独立、心理健康和生活质量，并检查结果的预测因素。所有参与者均被诊断患有医学上难治性的颞叶起源的复杂部分性癫痫发作，伴有或不伴有继发性全身性发作。在所有三个时间点均采用结构化临床访谈。获得了有关癫痫发作频率、抗癫痫药物、就业、驾驶状况、经济援助和独立生活的信息。此外，还包括有关生活质量、手术满意度以及是否存在抑郁或焦虑的问题。手术显着改善并持续了癫痫发作的结果。在第一次、第二次和第三次随访中，手术组中分别有 67%、72% 和 67% 的参与者在随访前一年保持无癫痫发作。在每次随访中，97%、84% 和 84% 的人表示他们将再次接受手术。癫痫发作自由度可以预测所有三个时间点的驾驶结果，但并不是就业、独立生活或财务独立的重要预测因素。与药物治疗组相比，手术组的心理社会生活结果随着时间的推移得到了改善和维持。这项系统性的长期调查为 ATL 对心理社会生活结果（包括驾驶、就业、独立生活和经济独立）的积极影响提供了强有力的支持。
At three time points, this study examined long-term psychosocial life outcomes of individuals who underwent anterior temporal lobectomy (ATL) compared to individuals with temporal lobe epilepsy that were medically managed. Participants were on average 17 years post-surgery. Seizure frequency, employment, driving, independent living, financial independence, mental health, and quality of life were examined at each follow-up assessment, and predictors of outcomes were examined. All participants were diagnosed with medically intractable complex partial seizures of temporal lobe origin with or without secondary generalization. A structured clinical interview was utilized at all three time points. Information was obtained regarding seizure frequency, anti-epilepsy medications, employment, driving status, financial assistance, and independent living. Additionally, questions regarding quality of life, satisfaction with surgery, and presence of depression or anxiety were included. Surgery resulted in significantly improved and sustained seizure outcomes. At the first, second, and third follow-ups 67%, 72%, and 67% of participants in the surgery group remained seizure free in the year prior to follow-up interview. At each follow-up, 97%, 84%, and 84% reported that they would undergo surgery again. Seizure freedom predicted driving outcomes at all three time points, but was not a significant predictor for employment, independent living or financial independence. Psychosocial life outcomes in the surgical group were improved and maintained over time when compared to the medically managed group. This systematic long-term investigation provides strong support for the positive impact of ATL on psychosocial life outcomes including driving, employment, independent living, and financial independence.