Nozaki Toshiki, Fujimoto Ayataka, Yamazoe Tomohiro, Niimi Keiko, Baba Shimpei, Yamamoto Takamichi, Sato Keishiro, Enoki Hideo, Okanishi Tohru
Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
Front Neurol. 2021 Feb 12;12:585191. doi: 10.3389/fneur.2021.585191. eCollection 2021.
We hypothesized that epilepsy surgery for adult patients with temporal lobe epilepsy (TLE) who obtained freedom from seizures could provide opportunities for these patients to continue their occupation, and investigated continuity of occupation to test this postulation. Data were obtained from patients who had undergone resective surgery for medically intractable TLE between October 2009 and April 2019 in our hospital. Inclusion criteria were as follows: (1) ≥16 years old at surgery; (2) post-operative follow-up ≥12 months; (3) seizure-free period ≥12 months. As a primary outcome, we evaluated employment status before and after surgery, classified into three categories as follows: Level 0, no job; Level 1, students or homemakers (financially supported by a family member); and Level 2, working. Neuropsychological status was also evaluated as a secondary outcome. Fifty-one (87.9%) of the 58 enrolled TLE patients who obtained freedom from seizures after surgery continued working as before or obtained a new job (employment status: Level 2). A significant difference in employment status was identified between before and after surgery ( = 0.007; Wilcoxon signed-rank test). Twenty-eight patients (48.3%) were evaluated for neuropsychological status both before and after surgery. Significant differences in Wechsler Adult Intelligence Scale-III scores were identified between before and after surgery ( < 0.05 each; paired -test). Seizure freedom could be a factor that facilitates job continuity, although additional data are needed to confirm that possibility. Further investigation of job continuity after epilepsy surgery warrants an international, multicenter study.
我们假设,接受癫痫手术且术后无癫痫发作的成年颞叶癫痫(TLE)患者能够获得继续工作的机会,并对职业连续性进行了调查以验证这一假设。数据来自于2009年10月至2019年4月间在我院因药物难治性TLE接受切除性手术的患者。纳入标准如下:(1)手术时年龄≥16岁;(2)术后随访≥12个月;(3)无癫痫发作期≥12个月。作为主要结局指标,我们评估了手术前后的就业状况,分为以下三类:0级,无工作;1级,学生或家庭主妇(由家庭成员提供经济支持);2级,有工作。神经心理状态作为次要结局指标也进行了评估。58例纳入研究的TLE患者中,有51例(87.9%)术后无癫痫发作,并继续从事之前的工作或找到了新工作(就业状况:2级)。手术前后就业状况存在显著差异( = 0.007;Wilcoxon符号秩检验)。28例患者(48.3%)在手术前后均接受了神经心理状态评估。手术前后韦氏成人智力量表第三版评分存在显著差异(每项 < 0.05;配对 -检验)。癫痫发作缓解可能是促进工作连续性的一个因素,尽管还需要更多数据来证实这一可能性。对癫痫手术后职业连续性的进一步研究需要开展一项国际多中心研究。