ABSTRACT
PURPOSE: Whereas the effect of anterior temporal lobectomy on seizure frequency is well recognized, less is known about its impact on work status. METHODS: One hundred thirty-four of 190 consecutive patients with temporal lobectomy participated in this study. Eligibility criteria were developed to ensure that only patients with the potential of achieving specific outcomes were included in the corresponding analyses. RESULTS: After surgery, significantly more patients were independent in activities of daily living (p < 0.001) or able to drive (p < 0.001). Income from work also increased (p < 0.01). Nearly one fifth of the patients who were eligible for analysis had either a gain (8%) or a loss (11%) of full- or of part-time work. Univariate analyses revealed the following factors to be associated with full-time work after surgery: student or full-time work within a year before surgery, full-time work experience before surgery, full- or part-time employment experience before surgery, no disability benefits before surgery, low postsurgical seizure frequency, improved postsurgical seizure control, excellent postsurgical seizure control, driving after surgery, and further education after surgery (p < 0.05). Significant factors on multivariate analysis were being a student or having full-time work within a year before surgery [odds ratio, 16.2 (95% CI, 4.3-60.5)], driving after surgery [15.2 (3.2-72.0)], and obtaining further education after surgery [9.2 (2.2-53.0)]. CONCLUSIONS: Anterior temporal lobectomy for intractable epilepsy improves activities of daily living and the ability to drive. Work outcome of this surgery is influenced by presurgical work experience, successful postsurgical seizure control especially to allow driving, and obtaining further education after surgery.
Subject(s)
Activities of Daily Living , Epilepsy, Complex Partial/surgery , Temporal Lobe/surgery , Work/statistics & numerical data , Adult , Analysis of Variance , Automobile Driving , Employment , Epilepsy, Complex Partial/rehabilitation , Female , Follow-Up Studies , Humans , Income , Male , Multivariate Analysis , Treatment OutcomeABSTRACT
The purpose of this study was to assess the extent to which people with epilepsy use recommended self-management strategies. Questionnaires on epilepsy self-management were mailed to 450 persons with epilepsy as part of a larger study on epilepsy self-management. One hundred ninety five people returned completed questionnaires and met the study criteria. The respondents were on average 35.8 years old and bad experienced seizures for a mean of 18.5 years. In general, the respondents reported compliance with medications but less adherence to other recommended practices such as safety and lifestyle behaviors. The results of this study offer some suggestions for nursing practice including an increased awareness of the teaching needs of persons with epilepsy.
Subject(s)
Epilepsy/rehabilitation , Self Care , Adolescent , Adult , Aged , Anticonvulsants/administration & dosage , Anticonvulsants/adverse effects , Epilepsy/nursing , Epilepsy/psychology , Epilepsy, Complex Partial/nursing , Epilepsy, Complex Partial/psychology , Epilepsy, Complex Partial/rehabilitation , Female , Humans , Life Style , Male , Middle Aged , Nursing Assessment , Patient Compliance/psychology , Patient Education as Topic , Rehabilitation, Vocational/psychology , Safety , Self Care/psychologySubject(s)
Epilepsy/rehabilitation , Pain, Intractable/rehabilitation , Cerebellum/physiopathology , Electrodes, Implanted , Epilepsy/etiology , Epilepsy/physiopathology , Epilepsy, Complex Partial/etiology , Epilepsy, Complex Partial/physiopathology , Epilepsy, Complex Partial/rehabilitation , Humans , Pain Threshold/physiology , Pain, Intractable/etiology , Pain, Intractable/physiopathology , Spinal Cord/physiopathology , Vagus Nerve/physiopathologyABSTRACT
A case history of a man with complex partial seizures resulting from a severe head injury following a road traffic accident is presented. Details of medical intervention and neuropsychological assessment are also presented and discussed, highlighting the difficulties of balancing therapeutic doses of anticonvulsant medication with cognitive functioning adequate to maintain expected quality of life. An interesting finding revealed that the patient's blood-sodium levels increased rather than decreased with rising doses of anticonvulsant medication.
Subject(s)
Epilepsy, Complex Partial/rehabilitation , Epilepsy, Post-Traumatic/rehabilitation , Head Injuries, Closed/rehabilitation , Adult , Anticonvulsants/therapeutic use , Carbamazepine/therapeutic use , Dose-Response Relationship, Drug , Epilepsy, Complex Partial/psychology , Epilepsy, Post-Traumatic/psychology , Follow-Up Studies , Head Injuries, Closed/psychology , Humans , Male , Multiple Trauma/psychology , Multiple Trauma/rehabilitation , Neuropsychological TestsABSTRACT
A questionnaire was sent to 511 patients with epilepsy who were being reviewed at the clinics of two consultant neurologists. The questionnaire asked 19 questions about seizure type and how the diagnosis was given. It also asked how much information was given about the disease and advice about living with it. There were also questions about counselling and preference for hospital or community care. Over 96% returned the questionnaire. About one third said they were not told what epilepsy was, over 90% wanted more information about the disease, and about three quarters felt they had not been given enough information about the side-effects of antiepileptic drugs. Over 60% wanted to talk to someone other than a consultant about epilepsy, the most frequent person requested being a specialist nurse. Despite this, three quarters wanted to continue to attend the hospital clinic and 89% were generally satisfied with their hospital management. This survey has highlighted a number of shortcomings in the structure of our clinics. It should be possible to correct them by providing more structured information and having a nurse specialist available.
