QUALITY OF LIFE AND SEIZURES AFTER EPILEPSY SURGERY

在医学上难治性癫痫相对常见。不受控制 研究表明，癫痫手术可以控制癫痫发作。 大多数入选的癫痫患者。然而，癫痫的价值 手术不仅取决于癫痫发作的控制，还取决于癫痫发作的改善 生活质量：身体功能、社会健康、认知、情绪 幸福感、角色功能、精力、痛苦、健康观念，以及 总体生活质量。这项研究的目标是：(1)开发一种 符合最高要求的标准化癫痫分类系统 通过评估患者与生活质量之间的关系 生活质量测量和癫痫发作结果的横断面研究； 评估手术后癫痫发生率随时间的变化 对生活质量的影响；(3)评估 一组建议的变量，如年龄和癫痫发作前的持续时间 手术、生活质量和癫痫结果测量；和(4) 通过比较生活质量评估手术干预的影响 与手术患者的癫痫预后有关 未接受手术的非随机对照组。这项研究 将基于239个方案的队列中预期收集的数据 患者在加州大学洛杉矶分校进行了长达15年的随访。两种生活质量 之前已经收集了84%的这些患者的测量结果 手术后；第三种，最近开发的生活质量仪器。 1990年，88%的在世患者完成了手术。这个 这三项指标在这个队列中的可靠性已经确定。 我们建议通过抽象详细信息来补充这个丰富的数据库 医疗记录中的临床信息，包括逐年 癫痫发作的发生、药物、发病年龄和癫痫持续时间， 并选取了术前无创检测结果等。一个 标准化的缉获分类系统将由 根据不同的不同对队列的癫痫结果进行分类 分类模型，然后评估与质量的关系 生活在随访中，根据最初的生活质量和其他因素进行调整 协变量。术后一段时间内癫痫发作结果的模式将 被评估。将使用多变量技术进行分析(1) 生活质量测量和关系的纵向变化 调整后的生活质量措施与癫痫控制之间的关系 对于临床病例变量，以及(2)手术效果 对混杂因素进行调整的干预。

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.