Epilepsy surgery: patient-perceived long-term costs and benefits

Purpose. The goal of this study was to assess the patient-perceived costs and benefits associated with the longer-term outcomes of epilepsy surgery in patients who underwent anterior temporal lobectomy or selective amygdalohippocampectomy. Methods. Surgery patients who were assessed in 1997 were reassessed in 2003. Demographic, clinical, and psychosocial details were collected using a validated self-completion questionnaire. Data were collected from 67 patients who had undergone surgery. Results. Forty-five percent were seizure-free. There were significant differences (P < 0.001) between the seizure-free (SF) and continuous seizure (CS) groups with respect to anxiety, depression, impact of epilepsy, self-esteem, mastery, stigma, affect balance, self-reported health, and quality of life. More SF patients were also employed and driving (P < 0.001). Despite these differences there were no differences for regret over surgery but there were differences for satisfaction and success ratings. Conclusions. Patients who were not SF, in the longer term, had little regret undergoing surgery but were less likely to be satisfied and had a poorer psychosocial profile. (C) 2003 Elsevier Inc. All rights reserved.