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Very long-term outcome in resected and non-resected patients with temporal lobe epilepsy with medial temporal lobe sclerosis: A multiple case-study.
- Source :
-
Seizure [Seizure] 2019 Apr; Vol. 67, pp. 30-37. Date of Electronic Publication: 2019 Feb 24. - Publication Year :
- 2019
-
Abstract
- Purpose: To investigate the very long-term (i.e., ≥15 years) seizure, cognitive and psycho-social outcomes in resected patients (RP) with TLE compared to control patients not having undergone epilepsy surgery.<br />Methods: We applied a multiple case-study design including three non-resected patients (NRP) who were compared to a group of six RP. The latter were matched to the NRP according to clinical-demographic data. Outcome measures were various seizure, cognitive, and psycho-social variables.<br />Results: Patients were 56-72 years old. Seizure and AED outcome was more favourable among RP. RP reported better self-perceived overall health but higher subjective memory complaints. Upon formal neuropsychological testing, RP presented with lower verbal memory scores. Very long-term memory decline was evident in left-sided RP with good baseline memory scores, while RP with lower baseline performance, right-sided RP and NRP remained stable. Seizure-freedom had remarkable effects on the relationship between objective and subjective outcome: seizure-free patients, in general, subjectively reported the best psychosocial and cognitive outcome - irrespective of neuropsychological test results.<br />Conclusion: Our study suggests positive effects of TLE surgery in the very long-term course of ≥15 years postoperatively. Long-term seizure-freedom appears to have the strongest impact on patients' subjectively perceived psycho-social and cognitive outcome and may even outweigh actual memory disturbances and/or decline. Overall, our data do not support the assumption of a generally accelerated cognitive decline in patients with TLE.<br /> (Copyright © 2019 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Aged
Cognition
Depression
Epilepsy, Temporal Lobe psychology
Female
Follow-Up Studies
Humans
Male
Memory
Memory Disorders etiology
Middle Aged
Postoperative Complications
Quality of Life
Seizures drug therapy
Seizures psychology
Seizures surgery
Time Factors
Treatment Outcome
Epilepsy, Temporal Lobe drug therapy
Epilepsy, Temporal Lobe surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2688
- Volume :
- 67
- Database :
- MEDLINE
- Journal :
- Seizure
- Publication Type :
- Academic Journal
- Accession number :
- 30870707
- Full Text :
- https://doi.org/10.1016/j.seizure.2019.02.015