Long-term mood, quality of life, and seizure freedom in intracranial EEG epilepsy surgery,Epilepsy & Behavior

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Long-term mood, quality of life, and seizure freedom in intracranial EEG epilepsy surgery
Epilepsy & Behavior ( IF 2.3 ) Pub Date : 2021-08-24 , DOI: 10.1016/j.yebeh.2021.108241
Oshi Swarup ₁ , Alexandra Waxmann ₂ , Jocelyn Chu ₃ , Simon Vogrin ₄ , Alan Lai ₂ , Joshua Laing ₃ , James Barker ₅ , Linda Seiderer ₃ , Sophia Ignatiadis ₃ , Chris Plummer ₄ , Ross Carne ₃ , Udaya Seneviratne ₆ , Mark Cook ₂ , Michael Murphy ₇ , Wendyl D'Souza ₂

Affiliation

Department of Medicine, St Vincent's Hospital Melbourne, The University of Melbourne, 41 Victoria Parade, Fitzroy, Victoria 3065, Australia; The University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia; Department of Medicine, Royal Melbourne Hospital, 300 Grattan Street, Parkville, Melbourne, Victoria 3050, Australia.
Department of Medicine, St Vincent's Hospital Melbourne, The University of Melbourne, 41 Victoria Parade, Fitzroy, Victoria 3065, Australia; The University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia.
Department of Medicine, St Vincent's Hospital Melbourne, The University of Melbourne, 41 Victoria Parade, Fitzroy, Victoria 3065, Australia.
Department of Medicine, St Vincent's Hospital Melbourne, The University of Melbourne, 41 Victoria Parade, Fitzroy, Victoria 3065, Australia; The University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia; Faculty of Health Arts and Design, Swinburne University of Technology, John St, Hawthorn, Victoria 3122, Australia.
The University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia; Department of Medicine, Royal Melbourne Hospital, 300 Grattan Street, Parkville, Melbourne, Victoria 3050, Australia.
Department of Medicine, St Vincent's Hospital Melbourne, The University of Melbourne, 41 Victoria Parade, Fitzroy, Victoria 3065, Australia; The University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia; Department of Neurosciences, Monash Medical Centre, 246 Clayton Rd, Clayton, Victoria 3168, Australia.
Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, 41 Victoria Parade, Fitzroy, Victoria 3065, Australia.

Objectives

To determine the long-term outcomes in patients undergoing intracranial EEG (iEEG) evaluation for epilepsy surgery in terms of seizure freedom, mood, and quality of life at St. Vincent’s Hospital, Melbourne.

Methods

Patients who underwent iEEG between 1999 and 2016 were identified. Patients were retrospectively assessed between 2014 and 2017 by specialist clinic record review and telephone survey with standardized validated questionnaires for: 1) seizure freedom using the Engel classification; 2) Mood using the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E); 3) Quality-of-life outcomes using the QOLIE-10 questionnaire. Summary statistics and univariate analysis were performed to investigate variables for significance.

Results

Seventy one patients underwent iEEG surgery: 49 Subdural, 14 Depths, 8 Combination with 62/68 (91.9%) of those still alive, available at last follow-up by telephone survey or medical record review (median of 8.2 years). The estimated epileptogenic zone was 62% temporal and 38% extra-temporal. At last follow-up, 69.4% (43/62) were Engel Class I and 30.6% (19/62) were Engel Class II-IV. Further, a depressive episode (NDDI-E > 15) was observed in 34% (16/47), while a ‘better quality of life’ (QOLIE-10 score < 25) was noted in 74% (31/42). Quality of life (p < 0.001) but not mood (p = 0.24) was associated with seizure freedom.

Significance

Long-term seizure freedom can be observed in patients undergoing complex epilepsy surgery with iEEG evaluation and is associated with good quality of life.

中文翻译：

颅内 EEG 癫痫手术的长期情绪、生活质量和无癫痫发作

目标

确定在墨尔本圣文森特医院接受癫痫手术的颅内脑电图 (iEEG) 评估患者在癫痫发作自由度、情绪和生活质量方面的长期结果。

方法

确定了 1999 年至 2016 年间接受 iEEG 的患者。2014 年至 2017 年期间，通过专科诊所记录审查和电话调查对患者进行了回顾性评估，其中包括：1) 使用 Engel 分类的无癫痫发作；2) 使用癫痫神经系统疾病抑郁量表 (NDDI-E) 的情绪；3) 使用 QOLIE-10 问卷的生活质量结果。进行汇总统计和单变量分析以研究变量的显着性。

结果

71 名患者接受了 iEEG 手术：49 名硬膜下、14 名深部、8 名联合手术，其中 62/68 (91.9%) 的患者仍然活着，可通过电话调查或医疗记录审查获得最后一次随访（中位数为 8.2 年）。估计的致痫区为 62% 颞区和 38% 颞区外。末次随访时，69.4%（43/62）为Engel I级，30.6%（19/62）为Engel II-IV级。此外，在 34% (16/47) 中观察到抑郁发作 (NDDI-E > 15) ，而在 74% (31/42) 中观察到“更好的生活质量”（QOLIE-10 评分 < 25）。生活质量（p < 0.001）而不是情绪（p = 0.24）与无癫痫发作相关。