Comparative assessment of patient’s quality of life under medical and surgical epilepsy treatment: an observational prospective study
Authors:   Federal State Budgetary Institution “Almazov National Medical Research Center” of the Ministry of Health of the Russian Federation, St. Petersburg, Russian Federation, Lebedeva E.N. , Abramov K.B. ,   Federal State Budgetary Institution “Almazov National Medical Research Center” of the Ministry of Health of the Russian Federation, St. Petersburg, Russian Federation, Samochernykh K.A. ,   Federal State Budgetary Institution “Almazov National Medical Research Center” of the Ministry of Health of the Russian Federation, St. Petersburg, Russian Federation, Dengina N.O. ,   Federal State Budgetary Institution “Almazov National Medical Research Center” of the Ministry of Health of the Russian Federation, St. Petersburg, Russian Federation, Odintsova G.V. ,   Federal State Budgetary Institution “Almazov National Medical Research Center” of the Ministry of Health of the Russian Federation, St. Petersburg, Russian Federation
Published: October 2024

Epilepsy has never been a purely medical problem; its social significance is well known. It is a global issue that affects people of all ages, races, and social classes in different countries and occurs in both men and women. Drug-resistant epilepsy is a form of the disease in which seizures persist despite appropriate therapy with two antiepileptic drugs, either as monotherapy or in combination. However, surgical treatment of drug-resistant epilepsy is still underutilized. The purpose of the study is to compare the level of quality of life in patients with drug-resistant epilepsy under medical treatment and 1 year after surgery in order to evaluate the dynamics in the areas of quality of life. The study design was a prospective case-control observation. The study included neurosurgical patients with a confirmed diagnosis of drug-resistant epilepsy divided into two groups: group 1 - patients in the preoperative phase receiving drug therapy with antiepileptic drugs, and group 2 - patients 1 year after surgical treatment of drug-resistant epilepsy. Demographic and clinical parameters were analyzed, and the Quality of Life in Epilepsy Inventory-31 survey was carried out before and 1 year after surgery. The first group consisted of 56 patients (55%), and the second group comprised 46 patients (45%). The overall mean quality of life score in group 1 was 53.5, and in group 2 – 59.9, which was statistically significantly different from group 1 (p=0.05). Of the 7 quality of life indicators, a statistically significant improvement was found in 2: general quality of life (p=0.01) and social functioning (p=0.01). 5 indicators showed no statistical differences between the groups: seizure worry (p=0.06), emotional well-being (p=0.9), energy/fatigue (p=0.5), cognitive function (p=0.7), and medication side effects (p=0.6). A comparative analysis of the quality of life of patients with pharmacoresistant epilepsy showed positive dynamics of quality of life from the first year after surgery in contrast to uncontrolled epilepsy against the background of medical treatment with antiepileptic drugs.