Abstract
Purpose: The medical benefits of epilepsy surgery
are well documented, but the psychosocial consequences of surgery have
received less attention. This is especially true of the roles of
expectations and satisfaction in postsugery functioning. The present study
was designed to examine the relationships between expectation,
satisfaction with surgery, and psychosocial functioning in patients and
their significant others before and after epilepsy surgery.
Methods: The neuropsychology findings of 79 patients undergoing
epilepsy surgery were examined from assessments made before, 2 months
after and 1 year after anterior temporal lobectomy (ATL) was performed.
The Minnesota Multiphasic Personality Inventory (MMPI) and the Washington
Psychosocial Seizure Inventory (WPSI) were used to assess psychosocial
functioning. A subset of 32 patients and their significant others were
followed prospectively with an addition semistructured interview to assess
expectations for and satisfaction with surgery outcome.
Results: Before surgery, patients showed considerable
problems with
psychosocial adjustment. After surgery, patients in the seizure-free
group showed improvements on the psychosocial measures at both follow-ups,
whereas patients with continued seizures showed improvement in the 2-month
follow-up and then a decline to baseline or worse at the time of the
1-year follow-up. Subjects who were studied prospectively had high
presurgery expectations for seizure elimination. After surgery, subjects
whose expectations were not met reported low satisfaction. Satisfaction
with surgery was associated with better psychosocial functioning.
Conclusions: Such data help elucidate the ways in which
successful
epilepsy surgery results in improved psychosocial functioning. The
results identify ways to increase the likelihood that both patients who
are seizure-free and those with reduced seizure frequency may benefit from
surgery.
Wheelock, I., Peterson, C. and Buchtel, H.A. (1998).
Pre-surgery expectations, post-surgery satisfaction, and psychosocial
adjustment following epilepsy surgery. Epilepsia, 39:487-494.
http://www-personal.umich.edu/~gusb/wheelock.html