Long-term follow-up of patients treated surgically for medically intractable epilepsy: results in 291 patients...

To assess the long-term outcome in patients who underwent surgical treatment of intractable epilepsy, we retrospectively reviewed the medical records of 291 consecutive Mayo patients treated between July 1972 and March 1985. We also evaluated the responses to a follow-up mailed questionnaire or telephone interview completed in 1992. Of the 291 patients, 245 (94% of the 261 patients known to be alive at the time of the survey) responded to the follow-up questioning. Information on the patients' neurologic status (including frequency of seizures, use of antiepileptic drugs, and self-reported assessment of functional capacity) and their overall satisfaction with the operative procedure and postoperative outcome were evaluated. Two hundred ninety patients survived the operation and were dismissed from the hospital. Of the 245 patients who responded to the follow-up survey, 41% and 58% had been free of seizures since surgical treatment and for 3 years preceding the follow-up survey, respectively. In addition, of the respondent cohort, 36% were successfully weaned off all antiepileptic drugs. Patients reported improvement in their daily functional capacity and quality of life after surgical treatment. For example, in comparison with the preoperative assessment, the patients' ability to obtain a driver's license was significantly increased, and seizure-related driving accidents, falls, and bodily injury significantly decreased. Furthermore, on the basis of current knowledge of the operation and its outcome, 85% reported that they would repeat the operative procedure. Thus, surgical treatment of intractable epilepsy is an effective option that is met with patient satisfaction.