Ahmad Faiz Uddin, Tripathi Manjari, Padma M V, Gaikwad Shailesh, Gupta Aditya, Bal C S, Sarkar Chitra, Gupta Surya, Wadhawan Ashima N, Sharma Bhavani S, Chandra Poodipedi Sarat
Department of Neurosurgery, Neurosciences Center, All India Institute of Medical Sciences, New Delhi-110 029, India.
Neurol India. 2007 Oct-Dec;55(4):343-8. doi: 10.4103/0028-3886.37093.
Outcome following epilepsy surgery has traditionally been measured in terms of relief of seizures. However, changes in health-related quality of life (HRQOL) after surgery for intractable epilepsy are also important to document. There are no studies on the Indian population which assess the outcome of epilepsy surgery in terms of HRQOL.
We conducted a prospective study on the patients undergoing epilepsy surgery for intractable seizures, between February 2004 and May 2006 at our center. All patients cleared for epilepsy surgery by the epilepsy surgery team were taken up for study. All patients
Thirty-six patients satisfying the inclusion/exclusion criteria were included in the analysis. Twenty-nine of these (Group 1) had good seizure outcome (Engel 1 and 2), while seven patients (Group 2) had poor seizure outcome (Engel 3 and 4) at six months. Overall, 77% of all study patients were completely seizure-free at follow-up. There was no baseline difference in the seven domains of QOLIE-31 between the two groups. There was very significant improvement (P value>0.005 using paired sample T test) in all the domains of QOLIE-31 in the good outcome group after surgery. Health-related quality of life improvement was seen in all the domains in the poor outcome group also, however, it was statistically significant only for the following parameters: seizure worry, overall QOL, emotional wellbeing, energy fatigue and social functioning domains. Improvement in seizure worry, overall QOL, emotional wellbeing and social functioning was significantly more in Group 1 as compared to Group 2.
Complete seizure-free state after surgery is associated with very significant improvement in HRQOL parameters. Several, but not all parameters of HRQOL as assessed by QOLIE-31, improved after surgery even in the poor seizure outcome group. The improvement in domains of seizure worry, overall QOL, emotional wellbeing and social functioning is significantly more in those patients in whom complete seizure-free state is achieved.
传统上，癫痫手术的结果是根据癫痫发作的缓解情况来衡量的。然而，记录难治性癫痫手术后健康相关生活质量（HRQOL）的变化也很重要。目前尚无针对印度人群评估癫痫手术HRQOL结果的研究。
2004年2月至2006年5月期间，我们在本中心对因难治性癫痫发作接受癫痫手术的患者进行了一项前瞻性研究。所有经癫痫手术团队批准进行癫痫手术的患者均纳入研究。所有患者
36例符合纳入/排除标准的患者纳入分析。其中29例（第1组）在6个月时癫痫发作结果良好（恩格尔1级和2级），而7例患者（第2组）癫痫发作结果不佳（恩格尔3级和4级）。总体而言，所有研究患者中有77%在随访时完全无癫痫发作。两组之间QOLIE - 31的七个领域在基线时无差异。手术后，良好结果组QOLIE - 31的所有领域均有非常显著的改善（使用配对样本t检验，P值>0.005）。结果不佳组的所有领域的健康相关生活质量也有改善，然而，仅在以下参数上具有统计学意义：癫痫发作担忧、总体生活质量、情绪健康、精力疲劳和社会功能领域。与第2组相比，第1组在癫痫发作担忧、总体生活质量、情绪健康和社会功能方面的改善更为显著。
手术后完全无癫痫发作状态与HRQOL参数的非常显著改善相关。即使在癫痫发作结果不佳的组中，手术后QOLIE - 3评估的HRQOL的几个但不是所有参数也有所改善。在实现完全无癫痫发作状态的患者中，癫痫发作担忧、总体生活质量、情绪健康和社会功能领域的改善更为显著。
