Article Summary by Dr. Autumn Klein:
This study asked 15 patients one year after anterior temporal lobectomy how they felt about their seizures recurring. Two thirds of patients were overall positive about the surgery because they had improvement in seizure number or severity. Themes patients commented on centered around continued use of seizure medication, acceptance of seizure recurrence and continued concerns over lack of autonomy. One third of patients who responded negatively to seizure recurrence were not depressed, but they may have had unrealistic expectations of possible surgery outcomes.
Comment: This is a nice study because it allowed patients to freely speak their thoughts on their seizure recurrence, a topic which is often not discussed openly. This article honestly discusses that seizures recur after surgery but it also demonstrates that after seizure recurrence, there are still positive outcomes.
Article Authors: Christopher A. Shirbin a, Anne M. McIntosh b,c, Sarah J. Wilson a,b,c,*
a School of Behavioural Science, University of Melbourne, Vic. 3010, Australia b Epilepsy Research Centre, Department of Medicine, University of Melbourne, Australia c Comprehensive Epilepsy Program, Austin Health, Melbourne, Australia
Article Abstract: Postoperative seizures occur in 20–60% of patients who have epilepsy surgery. Despite this, there is limited understanding of a patient’s experience of the recurrence of seizures after surgery. This study used a qualitative approach to identify key themes derived from content analysis of 15 in-depth patient interviews about the experience of seizure recurrence. The results showed a prominence of psychological issues over medical concerns. The four most frequently expressed themes were perceived success of surgery, medication, acceptance of seizure recurrence, and personal independence. Despite seizure recurrence, patient sentiments were not universally negative; rather there was heterogeneity of views, with some reporting ambivalence and others a sense of satisfaction with outcome. The findings provide evidence for the importance of cognitive reframing and benefit finding in the context of seizure recurrence. Copyright 2009 Elsevier Inc. All rights reserved.
I had an unrealistic view of life after surgery. Everyone had been so positive and I didn't want to let anyone down. At first I lied and didn't tell anyone about my first seizure after surgery for fear of being a failure. When I did it was horrible. My mother cried and my husband offered no sympathy. I never told my son. He thinks all is well since the surgery. The doctors still think it will get even better. It is interesting to wonder how much information really is out there about post surgery seizures as well as how and if seizures change.