Browsing by Author "Kantele, Oona"

Epilepsy surgery is an effective treatment in drug-resistant epilepsy and in addition to seizure reduction, surgery also seems to improve employment among epilepsy patients. While seizures and many psychosocial factors predict the employment outcome after epilepsy surgery, not all changes in employment observed over time can be attributed to these factors. This study investigated whether the level of cognitive functions or changes in cognitive functions predicted employment two years after the surgery. Furthermore, the study investigated whether changes in epileptic seizures, employment and cognitive functions could be observed after the surgery in comparison to pre-surgery level. For this registry study, data of 46 epilepsy surgery patients was acquired from medical reports and neuropsychological test records of HUS Neurocenter Neuropsychology unit. Predictors of postoperative employment were analyzed with univariate and multivariate logistic regression analysis. In this study 83% of the patients were seizure-free two years after the surgery. Employment status improved statistically significantly and 13 % of the patients not working preoperatively were employed or studying after the surgery. No change or only small changes were observed in cognitive functions after the surgery when compared to preoperative level. None of the changes in cognitive functions predicted employment after the surgery, but of the postoperative cognitive functions verbal reasoning (Similarities) and verbal fluency were significant predictors of postoperative employment, even though only verbal reasoning remained statistically significant in multivariate analysis. Seizure frequency was not associated with employment two years after the surgery. Of psychosocial factors employment pre-surgery and the number of antiepileptic drugs used were the strongest predictors of employment after the surgery. This study supports the earlier observations that good seizure outcome is not alone sufficient to explain the employment outcome after the surgery, but other predictors are likely to have an influence on employment as well. However, cognitive functions do not appear to have a significant effect on postoperative employment two years after the surgery, instead postoperative employment is best explained by preoperative employment and the number of antiepileptic drugs used.