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Where are they now? Psychosocial, educational, and vocational outcomes after epilepsy surgery in childhood
Author(s) -
Puka Klajdi,
Smith Mary Lou
Publication year - 2016
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.13327
Subject(s) - psychosocial , epilepsy , epilepsy surgery , population , medicine , vocational education , pediatrics , checklist , socioeconomic status , psychology , psychiatry , pedagogy , environmental health , cognitive psychology
Summary Objective To evaluate the social, educational, and vocational outcomes of young adults who underwent resective epilepsy surgery in childhood (4–11 years earlier), and in a comparison group of nonsurgical patients with intractable epilepsy. Methods Participants were 78 patients (mean age 22.37, standard deviation [ SD ] 2.47 years) with childhood onset intractable epilepsy, of whom 51 underwent surgery. At follow‐up, participants were at least 18 years of age. Patients' current education, employment, income, and various social factors, including living arrangements, relationship status, and involvement with friends and community organizations were recorded. In addition, parents of patients completed the Adult Behaviour Checklist ( ABCL ). Employment status, education, and income were compared with provincial census data. Results There was no statistically significant difference in the proportion of surgical and nonsurgical patients who were seizure‐free in the 12 months preceding the study: 53% and 33%, respectively (p = 0.10). Among all patients, 60% were enrolled in, or had completed, postsecondary education and 82% were employed or a student; similar to the general population. However, compared with population data, fewer patients with epilepsy (20%) had an annual income of $10,000 or greater (p < 0.001). Compared to normative data, a greater proportion of patients scored in the abnormal range in some ABCL scales (p < 0.028). Patients with IQ s > 85 had significantly better educational, vocational, and psychosocial outcomes compared to patients with IQ s ≤ 85. Surgical and nonsurgical patients did not differ on any outcome variable. Compared to patients with seizures, more seizure‐free patients were living independently (p = 0.03), and had a driver's licence (p < 0.001). Other outcomes were similar among patients with and without seizures. Significance Overall, patients with intractable epilepsy in childhood attained educational and vocational outcomes similar to that of the general population, but earned a significantly lower income. Seizure freedom, attained through surgery or medication management, was associated with better outcomes in limited psychosocial measures.