Studies and experience show that epilepsy surgery is
safe and effective when the seizure focus is accessible to excision without risk
of intellectual, language or significant focal weakness or numbness. When the
surgery is done in childhood and adolescence, the long-term employment outcomes
were similar to the employment histories of the general population.
Investigators evaluated the Swedish National Epilepsy
Surgery Register in this study.1 They obtained data on 203
individuals with childhood-onset epilepsy who underwent epilepsy surgery between
1995 and 2012 when they were under 18 years of age (mean age 13.6 years). Participants’
pre-operative IQ (intelligence quotient) scores were 70 and above. Surgery
did not appear to have any significant deleterious effect on IQ. A typical
adult has an average IQ score of 105 with a standard deviation of 20; i.e. typical
adults have an IQ between 85 and 125. Scores of 70-84 are below average but do
not preclude success in social and family relationships and meaningful,
productive employment.
This study found that most surgery patients obtained
at least a high school diploma or equivalent within 5 years after surgery. The
employment rates at 5 years post-surgery were 44 percent and by the 20 year
follow-up 77 percent were gainfully employed. These findings for seizure-free
patients were comparable to the general population. Wages, occupational
complexity and the extent of part-time employment data were not available.
Non-seizure-free patients’ work histories would presumably be somewhat less
than the above figures.
Excellent long-term vocational outcomes are
achievable after pediatric epilepsy-surgery. I encourage your consideration of
possible epilepsy surgery with your neurologists.
1)
Reinholdson J., Olsson I, Tranberg
A E; Long-term employment outcomes after
epilepsy surgery in childhood. Neurology 2020; vol 94: Number 2, p 70: e205-e216.
Doi:10.1212.
Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of
Medicine at UCLA.
“DINGS” is his
first novel. It is a mother’s dramatic story that teaches epilepsy, now available in eBook, audiobook
and soft cover editions.
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