QUALITY OF LIFE AND SEIZURES AFTER EPILEPSY SURGERY

难治性癫痫相对常见。 不受控 研究表明，手术治疗癫痫导致癫痫发作控制， 大多数癫痫患者。 然而，癫痫的价值 手术不仅取决于癫痫的控制， 生活质量：身体功能、社会健康、认知、情绪 幸福感、角色功能、能量、疼痛、健康感知，以及 整体生活质量。 本研究的目的是：（1）开发一个 标准化的缉获分类系统， 与患者的生活质量之间的关系 横断面的生活质量指标和癫痫发作结局;（2） 评价术后癫痫发作发生率随时间的变化， 对生活质量的影响;（3）评估a 一组建议的变量，如年龄和癫痫发作前的持续时间 手术和生活质量以及癫痫结局指标;以及（4） 通过比较生活质量来评估手术干预的影响 和癫痫发作的结果， 未接受手术的非随机对照组。 研究 将基于前瞻性收集的239例方案队列数据 患者在加州大学洛杉矶分校接受了长达15年的随访。 两种生活质量 之前已经收集了84%的这些患者的测量数据， 手术后;第三个，最近开发的，生活质量的工具。 在1990年有88%的病人完成了这项手术。 的 这三个指标在这一组群中的可靠性已经确立。 我们建议通过抽象详细信息来补充这个丰富的数据库 来自医疗记录的临床信息，包括逐年信息 癫痫发作发生率、药物、癫痫发作时的年龄和癫痫持续时间， 以及选定的术前非侵入性测试结果等。 一 将制定标准化的缉获分类系统， 将队列的癫痫发作结果根据不同的 分类模型，然后评估与质量的关系， 随访时的生活，调整初始生活质量和其他 协变量 术后癫痫发作结果随时间变化的模式将 被评价。 将使用多变量技术分析（1） 生活质量测量和关系的纵向变化 生活质量测量和癫痫控制之间的关系，调整后 对于临床病例组变量，以及（2）手术的影响 调整混杂因素的干预。

Medically intractable epilepsy is relatively common. Uncontrolled studies suggest that surgery for epilepsy leads to seizure control in a majority of selected epilepsy patients. However, the value of epilepsy surgery depends not only on seizure control but also on improvement in quality of life: physical function, social health, cognition, emotional well-being,role functioning, energy, pain, health perceptions, and overall quality of life. The goals of this study are: (1) to develop a standardized seizure classification system that corresponds most highly with patients' quality of life by evaluating relationships between quality of life measures and seizure outcomes cross-sectionally; (2) to evaluate changes in post-surgical seizure occurrence over time and effects on quality of life; (3) to evaluate the relationships between a set of proposed variables such as age and duration of epilepsy prior to surgery and quality of life and seizure outcome measures; and (4) to estimate the impact of surgical intervention by comparing quality of life and seizure outcomes in surgical patients with outcomes in a nonrandomized comparison group who did not undergo surgery. The study will be based on data collected prospectively on a cohort of 239 protocol patients followed for up to 15 years at UCLA. Two quality-of-life measures have been collected on 84 percent of these patients before and after surgery; a third, recently developed, quality-of-life instrument. was completed by 88 percent of all living patients in 1990. The reliability of these three measures in this cohort has been established. We propose to supplement this rich data base by abstracting detailed clinical information from the medical records, including year-by-year seizure occurrence, medications, age at onset and duration of epilepsy, and selected pre-operation noninvasive test results, among others. A standardized seizure classification system will be developed by classifying the cohort's seizure outcomes according to different classification models, then evaluating the relationship to quality of life at follow-up, adjusting for initial quality of life and other covariates. Patterns of seizure outcome over time postoperatively will be evaluated. Multivariate techniques will be used to analyze (1) longitudinal changes in quality-of-life measures and relationships between quality-of-life measures and seizure control, after adjustment for clinical casemix variables, and (2) the effect of surgical intervention with adjustment for confounders.