Pre- and postoperative socioeconomic development of 151 patients with focal epilepsies

Abstract

Purpose: We evaluated retrospectively the socioeconomic development of epilepsy patients after temporal or extratemporal epilepsy surgery and analyzed the relationship to clinical and neuropsychological data. Methods: 151 patients (from ages 11-65 years; mean postoperative follow-up: 3 years) replied to a structured questionnaire, which referred to objective data of the patient's educational and vocational development. Neuropsychological data were obtained from pre- and postoperative (1-year follow-up) examinations. Results: The preoperative development data indicated that patients exposed to epilepsy at any developmental stage had a higher prevalence of educational/vocational difficulties as compared with patients with a later onset of epilepsy. Postoperatively, the integration of the formerly unemployed improved and the unemployment rate decreased from 33 to 16% out of those patients who had been schooled or who were employed, 79%-91% made progress in development, or were at least able to keep their status. Only 2 of 14 patients, who had been retired early because of their epilepsy, returned to employment. In general, a deterioration of the socioeconomic status was significantly related to insufficient seizure control. A reemployment of patients who were formerly unemployed depended mainly on age and neuropsychological outcome. Conclusions: Our results suggest that early and successful surgical intervention improves or at least maintains the socioeconomic situation, especially the employment status.