Patients' Aims for Epilepsy Surgery: Desires Beyond Seizure Freedom

Authors


Address correspondence and reprint requests to Dr. D. C. Taylor at David Lewis Centre for Epilepsy, Mill Lane, Warford, Nr Alderley Edge, Cheshire, SK9 7UI, U.K. 353-1-809 3000

Abstract

Summary:  Purpose: To evaluate prospectively patient's aims for epilepsy surgery as previously outlined theoretically by Taylor et al. (Epilepsia 1997;3:625–30).

Methods: Ninety-three consecutive patients were interviewed by a psychiatrist as part of their evaluation for epilepsy surgery. Open-ended questions about the patient were asked, and carers' aims or ambitions for change as a result of putative relief of seizures were elicited. The interviewer aimed to obtain a maximum of five aims for later follow-up purposes. These questions were part of an extensive psychiatric interview that is described.

Results: The aims of 69 patients or carers were analyzed. The 204 statements of aims were grouped into 59 categories initially. The five most frequently cited constituted 50% of all the aims listed. These aims were desire for work, driving of motor vehicles, independence, socializing, and freedom from drugs. The patients rarely identified a desire for improvement in cognitive functioning as an aim for epilepsy surgery. A final analysis into six categories showed that changes in social process predominated, even over changes in personal behavior.

Conclusions: The social and personal aims to accompany relief of epilepsy identified by patients are consistent with the literature on psychosocial adjustment to epilepsy.

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