van Empelen Ron, Jennekens-Schinkel Aag, van Rijen Peter C, Helders Paul J M, van Nieuwenhuizen Onno
Department of Pediatric Physical Therapy and Exercise Physiology, University Medical Center-Wilhelmina Children's Hospital, Utrecht, The Netherlands.
Epilepsia. 2005 Feb;46(2):258-71. doi: 10.1111/j.0013-9580.2005.27304.x.
To measure outcome of epilepsy surgery in terms of health-related quality of life (HrQoL) and self-perceived competence of children and adolescents.
Prospective longitudinal follow-up study of 21 patients (aged 6.2 to 16.8 years). Frequency and severity of seizures and epilepsy-related restrictions, HrQoL, and self-perceived competence were rated before and 6, 12, and 24 months after epilepsy surgery. Data were analysed nonparametrically and using analysis of variance for repeated measures.
Group-wise, seizure parameters had almost normalized 6 months after surgery (p<0.001) and remained so. Two years after surgery, 15 (72%) patients were free of seizures. At the first postsurgical assessment, parents and children evaluated the frequency of activities as improved and that of seizures as diminished (p<0.05). Parents evaluated their children as having positive emotions more frequently (p<0.05). Children started to feel better about seizure variables in the second year after surgery. Two years after surgery, children perceived themselves as being socially more competent and having greater self-worth (p=0.05). In the adolescent group, several aspects of self-perceived competence improved shortly after surgery (p<0.05), whereas 2 years after surgery, athletic competence and romance had improved (p<0.05).
In children and adolescents, epilepsy surgery sets the stage for improvement in HrQoL and in competence to participate in social and societal domains. Most improvement occurs in the first 6 months after surgery.
从健康相关生活质量(HrQoL)以及儿童和青少年的自我感知能力方面衡量癫痫手术的效果。
对21例患者(年龄6.2至16.8岁)进行前瞻性纵向随访研究。在癫痫手术前以及术后6、12和24个月,对癫痫发作的频率和严重程度、与癫痫相关的限制、健康相关生活质量以及自我感知能力进行评分。数据采用非参数分析以及重复测量方差分析。
总体而言,术后6个月癫痫发作参数几乎已恢复正常(p<0.001)且持续如此。术后两年,15例(72%)患者无癫痫发作。在首次术后评估时,家长和孩子评估活动频率有所改善,癫痫发作频率降低(p<0.05)。家长评估孩子更频繁地表现出积极情绪(p<0.05)。孩子在术后第二年开始对癫痫发作相关变量感觉更好。术后两年,孩子认为自己在社交方面更有能力且自我价值更高(p=0.05)。在青少年组,术后不久自我感知能力的几个方面有所改善(p<0.05),而术后两年,运动能力和恋爱方面有所改善(p<0.05)。
对于儿童和青少年,癫痫手术为改善健康相关生活质量以及参与社会和社交领域的能力奠定了基础。大多数改善发生在术后的前6个月。