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Five years after surgery,62 patients(70%)were seizure free,8(9%)had seizures on fewer than 3 days per year or exclusively had nocturnal seizures,10(11%)had greater than 80%reduction in seizure frequency,5(6%) had less than 80%reduction in seizure frequency,and 4(4%)died of causes unrelated to surgery.The proportion of patients in each outcome class remained stable throughout the 5-year period.Fifty-five percent of seizure recurrences happened within 6 months of surgery,and 93%occurred within 2 years after surgery.Outcome at 1 year related only moderately will to outcome at 5 years.No significant cognitive or linguistic deficits occurred.All patients who died had persistent seizures after surgery. Underemployment and unemployment declined significantly after surgery,with improvement noted in seizure-free patients.Temporal lobectomy provides sustained seizure relief over 5 years to most patients who have surgery. Outcome at 2 years predicts long-term outcome.A seizure-free state is associated with reduced mortality and increased employment.Mere reduction in seizure frequency is not associated with improvement in those measures. |
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