Abstract

PurposeFrontal lobe resection (FLR) is the second most common epilepsy surgery procedure in adults. Few studies address neuropsychological consequences after FLR. The aim of this study was to explore patients’ and relatives’ experiences of cognitive, emotional and social cognitive functioning after frontal lobe epilepsy surgery. MethodsSemi-structured interviews were held with 14 patients having gone through FLR as adults during the years 2000–2016 and 12 of their relatives. Interviews were audio-recorded, transcribed and analyzed with inductive qualitative content analysis. ResultsPositive as well as negative consequences were described both by patients and relatives. Feelings of relief and an increased capacity to experience emotions of well-being were mainly experienced as related to seizure freedom. A newfound autonomy and a more grown-up identity as opposed to a self-image based on epilepsy was also highlighted. However, results also showed that even for seizure free patients, FLR could give rise to negative experiences, the most prominent of which were mental fatigue, lowered mood and social withdrawal. Coping strategies included planning ahead to avoid mental exhaustion. Over all, respondents considered that the epilepsy surgery had been a risk well worth taking and that positive consequences outweighed the negative ones. ConclusionsThis study shows a range of positive as well as negative outcomes after FLR for epilepsy. The findings indicate that lowered mood and mental fatigue could affect the life situation in a negative way, regardless of seizure outcome. This is important to consider in the preoperative counselling of patients and their families, as well as in the postsurgical follow-up. It is also crucial that the epilepsy surgery team has the possibility to offer rehabilitation and support to families regarding these aspects after surgery.

Highlights

  • Epilepsy surgery is a well-documented treatment for a selected group of patients with drug-resistant focal epilepsy [1,2,3]

  • The theme was derived from the categories below and illustrates respondents’ different as well as shared experiences from frontal lobe epilepsy surgery

  • Experiences range from very positive outcomes with increased autonomy and more joy in life, illustrated by the category ‘‘Increased zest for life”, to descriptions of increased psychological distress, mental fatigue, and social withdrawal which are included in the category ‘‘Withdrawal from social interaction”

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Summary

Introduction

Epilepsy surgery is a well-documented treatment for a selected group of patients with drug-resistant focal epilepsy [1,2,3]. There are several possible explanations for this, one of them being that the patient group is heterogeneous regarding resected area within the frontal lobes. Another is that the frontal lobes themselves accommodate a number of various and complex functions that are not easy to assess with neuropsychological tests or rating scales [7,8].

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