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Dissertation
Postoperative outcome of temporal lobectomy: a multivariable model of cognitive, emotional and psychosocial functioning in epilepsy
Doctor of Philosophy (Ph.D.), Drexel University
Nov 1998
DOI:
https://doi.org/10.17918/00000810
Abstract
Temporal lobe epilepsy is a common neurological disease which affects physical, cognitive and emotional functioning. It is well accepted that cognitive deficits are a result of the underlying pathology of epilepsy. Although the cause of emotional disturbances is less understood, it is generally agreed that emotional disturbances are due to a combination of neurological factors and secondary symptoms related to living with a chronic illness such as epilepsy. Temporal lobectomy provides a last resort treatment for those with intractable epilepsy. Cognitive and emotional sequelae are common after surgery. However, the relationship of these sequelae, in addition to preoperative levels of functioning, remains unclear. The aim of this study is to further understand the complex relationship of changes in cognitive functioning to the emotional and psychosocial functioning of temporal lobe epilepsy patients after temporal lobectomy. Eleven right (RTLE) and nine left (LTLE) temporal lobectomy patients were included in the study, with a mean age of 35.2 years, and 13.1 years of education. A full battery of neuropsychological measures, as well as the Personality Assessment Inventory and the Washington Psychosocial Seizure Inventory were administered to each patient before, and one year after temporal lobectomy. Analyses revealed relatively mild emotional and psychosocial dysfunction prior to surgery. Only those patients who were seizure free after surgery (70%) showed improved emotional and psychosocial functioning postoperatively. The RTLE group showed a more global reduction in distress than did the LTLE group. In terms of cognitive functioning, an improvement was seen in memory in only those RTLE patients who were rendered seizure free. Changes in several areas of cognitive functioning were correlated with postoperative psychosocial and emotional functioning; increases in memory were associated with decreased difficulties in family relations, and improvements in visual skills were related to decreased difficulties in vocational adjustment. However, no relationship was found between postoperative cognitive functioning and depression or anxiety. Overall, preoperative psychosocial adjustment, including emotional, interpersonal, and vocational adjustment, adjustment to seizures, medication and medical management, and anxiety have a stronger relationship to psychosocial outcome than cognitive changes, seizure control, and side of surgery. Additional research is needed to further quantify this relationship.
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Details
- Title
- Postoperative outcome of temporal lobectomy
- Creators
- Amy Deborah Gordon
- Contributors
- Eric Zillmer (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- viii, 125 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Psychology, Sociology, and Anthropology [Historical]; College of Arts and Sciences; Drexel University
- Other Identifier
- 991014970210404721