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Life Outcomes of Anterior Temporal Lobectomy: Serial Long-term Follow-up Evaluations

Jones, Jana E. PhD*; Blocher, Jacquelyn B. BA; Jackson, Daren C. PhD*

doi: 10.1227/NEU.0000000000000145
Research-Human-Clinical Studies

BACKGROUND: At 3 time points, this study examined long-term psychosocial life outcomes of individuals who underwent anterior temporal lobectomy in comparison with individuals with temporal lobe epilepsy who were medically managed.

OBJECTIVE: To examine seizure frequency, employment, driving, independent living, financial independence, mental health, and quality of life at each follow-up assessment, as well as predictors of outcomes.

METHODS: All participants were diagnosed with medically intractable complex partial seizures of temporal lobe origin with or without secondary generalization. A structured clinical interview was used at all 3 time points. Information was obtained regarding seizure frequency, antiepilepsy medications, employment, driving status, financial assistance, and independent living. Additionally, questions regarding quality of life, satisfaction with surgery, and the presence of depression or anxiety were included. Participants were, on average, 17 years postsurgery.

RESULTS: Surgery resulted in significantly improved and sustained seizure outcomes. At the first, second, and third follow-ups, 67%, 72%, and 67% of participants in the surgery group remained seizure-free in the year before the follow-up interview. At each follow-up, 97%, 84%, and 84% reported that they would undergo surgery again. Seizure freedom predicted driving outcomes at all 3 time points, but was not a significant predictor for employment, independent living, or financial independence. Psychosocial life outcomes in the surgical group were improved and maintained over time in comparison with the medically managed group.

CONCLUSION: This systematic long-term investigation provides strong support for the positive impact of anterior temporal lobectomy on psychosocial life outcomes including driving, employment, independent living, and financial independence.

ABBREVIATIONS: ATL, anterior temporal lobectomy

M, mean

MMPI, Minnesota Multiphasic Personality Inventory

SD, standard deviation

*University of Wisconsin School of Medicine & Public Health, Department of Neurology, Madison, Wisconsin;

Long Island University, Department of Psychology, Brookville, New York

Correspondence: Jana E. Jones, PhD, University of Wisconsin School of Medicine & Public Health, Department of Neurology, 1685 Highland Ave, Medical Foundation Centennial Building, Room 7229, Madison, WI 53705. E-mail: jejones@neurology.wisc.edu

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Received April 23, 2013

Accepted August 23, 2013

Copyright © by the Congress of Neurological Surgeons