Changes in the quality of life of children after surgical treatment for drug-resistant temporal lobe epilepsy
https://doi.org/10.14412/2074-2711-2019-1-48-52
Abstract
Objective: to evaluate the impact of surgical treatment for drug-resistant temporal lobe epilepsy in children on seizure frequency and quality of life.
Patients and methods. Examinations were made in 80 children aged 2–17 years with drug-resistant temporal lobe epilepsy, who had undergone surgery in 2011–2016. To assess its outcomes, the investigators used the Quality of Life Childhood Epilepsy, QOLCE questionnaire for patients' parents and the Engel Epilepsy Surgery Outcomes Scale.
Results and discussion. In the long-term period after surgical treatment, 54.5% of the children with drug-resistant temporal lobe epilepsy achieved a favorable outcome (Engel class I); there were significant (p<0.05) positive changes in quality of life subdomains, such as speech, physical limitations, energy levels/weakness, and overall quality of life. Comparison of quality of life before and after surgical treatment established its positive impact on subdomains, such as social contacts and activity, behavior, physical limitations, attentiveness, memory, and speech. In general, there was a neutral or beneficial effect of the treatment on most of the quality of life subdomains.
Conclusion. To make recommendations based on high-level evidence, there is a need for further multicenter prospective studies of large patient populations with a detailed analysis of the relationship of factors influencing the outcome of surgery and indicators of psychosocial well-being of a child. The preoperative and postoperative changes in health and quality of life indicators cannot be more accurately assessed in patients without standardizing their preoperative examination algorithm and using equivalent psychometric tools.
About the Authors
K. B. Abramov
V.A. Almazov National Medical Research Center, Ministry of Health of Russia
Russian Federation
Russian Federation
Konstantin Borisovich Abramov
2, Akkuratov St., Saint Petersburg 197341
D. A. Sarsembaeva
V.A. Almazov National Medical Research Center, Ministry of Health of Russia
Russian Federation
Russian Federation
2, Akkuratov St., Saint Petersburg 197341
V. A. Khachatryan
V.A. Almazov National Medical Research Center, Ministry of Health of Russia
Russian Federation
Russian Federation
2, Akkuratov St., Saint Petersburg 197341
References
1. Baumer F, Cardon A, Porter B. Language Dysfunction in Pediatric Epilepsy. J Pediatr. 2018 Mar;194:13-21. doi: 10.1016/j.jpeds.2017.10.031. Epub 2017 Dec 11.
2. Guzeva OV, Guzeva VI, Guzeva VV, et al. The results of an evaluation of quality of care and life in children with epilepsy. Pediatr. 2017;8(2):32-43. (In Russ.).
3. Baxendale S, Thompson P. Red flags in epilepsy surgery: Identifying the patients who pay a high cognitive price for an unsuccessful surgical outcome. Epilepsy Behav. 2018 Jan; 78:269-272. doi: 10.1016/j.yebeh.2017.08.003. Epub 2017 Nov 5.
4. Warf B. Surgery for epilepsy: the need for global acceptance and access. Lancet Neurol. 2016 Aug;15(9):898-899. doi: 10.1016/S1474-4422(16)30141-7.
5. Holm E, Foged MT, Beniczky S, et al. Efficacy of the Danish epilepsy surgery programme. Acta Neurol Scand. 2018 Feb; 137(2):245-251. doi: 10.1111/ane.12857. Epub 2017 Oct 10.
6. Guan J, Karsy M, Ducis K, Bollo RJ. Surgical strategies for pediatric epilepsy. Transl Pediatr. 2016 Apr;5(2):55-66. doi: 10.21037/tp.2016.03.02.
7. Ramantani G, Reuner G. Cognitive Development in Pediatric Epilepsy Surgery. Neuropediatrics. 2018 Apr;49(2):93-103. doi: 10.1055/s-0037-1609034. Epub 2017 Dec 5.
8. Qualmann KJ, Spaeth CG, Myers MF, et al. Pediatric epilepsy surgery: The prognostic value of central nervous system comorbidities in patients and their families. J Child Neurol. 2017 Apr;32(5):467-474. doi: 10.1177/0883073816685653. Epub 2017 Jan 6.
9. Mukhin KYu, Pylaeva OA. The formation of cognitive and mental disorders in epilepsy: the role of various factors associated with disease and treatment (a review of literature and case reports). Russkii zhurnal detskoi nevrologii. 2017;12(3):3-13. (In Russ.).
10. Sabaz M, Lawson J, Cairns D, et al. The impact of epilepsy surgery on quality of life in children. Neurology. 2006 Feb 28;66(4):557-61.
11. Reuner G, Kadish NE, Doering JH, et al. Attention and executive functions in the early course of pediatric epilepsy. Epilepsy Behav. 2016 Jul;60:42-49. doi: 10.1016/j.yebeh.2016.04.011. Epub 2016 May 11.
12. Kanner AM. Management of psychiatric and neurological comorbidities in epilepsy. Nat Rev Neurol. 2016 Feb;12(2):106-16. doi: 10.1038/nrneurol.2015.243. Epub 2016 Jan 18.
13. Melikyan EG, Gekht AB. Life quality in epileptic patients. Lechebnoe delo. 2011;(1):4-9. (In Russ.).
14. Nickels KC, Zaccariello MJ, Hamiwka LD, Wirrell EC. Cognitive and neurodevelopmental comorbidities in paediatric epilepsy. Nat Rev Neurol. 2016 Aug;12(8):465-76. doi: 10.1038/nrneurol.2016.98. Epub 2016 Jul 22.
15. Wiebe S. Epilepsy: Does access to care influence the use of epilepsy surgery? Nat Rev Neurol. 2016 Mar;12(3):133-4. doi: 10.1038/nrneurol.2016.7. Epub 2016 Jan 29.
16. Khachatryan VA, Mamatkhanov MR, Shershever AS. Diagnostika i lechenie progredientnykh form epilepsii [Diagnosis and treatment of progradient forms of epilepsy]. Saint-Petersburg: Desyatka; 2008. 264 p.
17. Schiltz NK, Fernandez-Baca Vaca G. Epidemiologist's view: Addressing the epilepsy surgery treatment gap with minimally-invasive techniques. Epilepsy Res. 2018 May;142: 179-181. doi: 10.1016/j.eplepsyres.2018.01.013. Epub 2018 Feb 1.
18. Shen A, Quaid KT, Porter BE. Delay in pediatric epilepsy surgery: A caregiver's perspective. Epilepsy Behav. 2018 Jan;78:175-178. doi: 10.1016/j.yebeh.2017.10.014. Epub 2017 Nov 7.
19. Khachatryan VA, Mamatkhanov MR, Shershever AS. Nespetsificheskie metody khirurgicheskogo lecheniya epilepsii [Non-specific methods of surgical treatment of epilepsy]. Tyumen': Tyumenskii gosudarstvennyi universitet; 2016. 544 p.
20. Cross JH, Vezyroglou K. Selecting the right paediatric patient for epilepsy surgery. Paediatr Child Health (Oxford). 2017:1-5. https://doi:10.1016/j.paed.2017.03.003
21. Sabaz M, Cairns DR, Lawson J, et al. Validation of a new quality of life measure for children with epilepsy. Epilepsia. 2000 Jun; 41(6):765-74.
22. Lebedev KE, Mamatkhanov MR. Indications and general principles for surgical treatment of epilepsy (review). Neirokhirurgiya i nevrologiya detskogo vozrasta. 2016;(2):66–78. (In Russ.).
23. Abramov KB, Asatryan EA, Tadevosyan AR. Current issues of epilepsy surgery. 2017;(3): 36–48. (In Russ.).
24. Choi SA, Kim SY, Kim H, et al. Surgical outcome and predictive factors of epilepsy surgery in pediatric isolated focal cortical dysplasia. Epilepsy Res. 2018 Jan;139:54-59. doi: 10.1016/j.eplepsyres.2017.11.012. Epub 2017 Nov 27.
25. Hosoyama H, Matsuda K, Mihara T, et al. Long-term outcomes of epilepsy surgery in 85 pediatric patients followed up for over 10 years: a retrospective survey. J Neurosurg Pediatr. 2017 May;19(5):606-615. doi: 10.3171/2016.12.PEDS16197. Epub 2017 Mar 3.
Review
For citations:
Abramov K.B., Sarsembaeva D.A., Khachatryan V.A. Changes in the quality of life of children after surgical treatment for drug-resistant temporal lobe epilepsy. Neurology, Neuropsychiatry, Psychosomatics. 2019;11(1):48-52. (In Russ.) https://doi.org/10.14412/2074-2711-2019-1-48-52
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