Initial outcomes in the Multicenter Study of Epilepsy Surgery

Susan S. Spencer*, A. T. Berg, B. G. Vickrey, M. R. Sperling, C. W. Bazil, S. Shinnar, J. T. Langfitt, T. S. Walczak, S. V. Pacia, N. Ebrahimi, D. Frobish

*Corresponding author for this work

Research output: Contribution to journalArticle

166 Scopus citations

Abstract

Objective: To obtain prospective data regarding seizures, anxiety, depression, and quality of life (QOL) outcomes after resective epilepsy surgery. Methods: The authors characterized resective epilepsy surgery patients prospectively at yearly intervals for seizure outcome, QOL, anxiety, and depression, using standardized instruments and patient interviews. Results: Of 396 patients who underwent resective surgical procedures, 355 were followed for at least 1 year. Of these, 75% achieved a 1-year remission at some time during follow-up; patients with medial temporal (77%) were more likely than neocortical resections (56%) to achieve remission (p = 0.01). Relapse occurred in 59 (22%) patients who remitted, more often in medial temporal (24%) than neocortical (4%) resected patients (p = 0.02). QOL, anxiety, and depression all improved dramatically within 3 months after surgery (p < 0.0001), with no significant difference based on seizure outcome. After 3 months, QOL in seizure-free patients further improved gradually, and patients with seizures showed gradual declines. By 12 and 24 months, overall QOL and its epilepsy-targeted and physical health domains were significantly different in the two outcome groups. (Anxiety and depression scores also gradually diverged, with improvements in seizure-free and declines in continued seizure groups, but differences were not significant.) Conclusion: Resective surgery for treatment of epilepsy significantly reduces seizures, most strikingly after medial temporal resection (77% 1 year remission) compared to neocortical resection (56% 1 year remission). Resective epilepsy surgery has a gradual but lasting effect on QOL, but minimal effects on anxiety and depression. Longer follow-up will be essential to determine ultimate seizure, QOL, and psychiatric outcomes of epilepsy surgery.

Original languageEnglish (US)
Pages (from-to)1680-1685
Number of pages6
JournalNeurology
Volume61
Issue number12
DOIs
StatePublished - Dec 23 2003

ASJC Scopus subject areas

  • Clinical Neurology

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    Spencer, S. S., Berg, A. T., Vickrey, B. G., Sperling, M. R., Bazil, C. W., Shinnar, S., Langfitt, J. T., Walczak, T. S., Pacia, S. V., Ebrahimi, N., & Frobish, D. (2003). Initial outcomes in the Multicenter Study of Epilepsy Surgery. Neurology, 61(12), 1680-1685. https://doi.org/10.1212/01.WNL.0000098937.35486.A3