Edelvik A, et al. – This prospective, controlled, long–term follow–up study aimed to assess health–related quality of life (HRQOL) and emotional well–being after epilepsy surgery. Compared to after 2 years, HRQOL was stable 14 years after surgery at the group level. Social Functioning and Mental Health were still below, however, other domains were comparable to the normative sample. As per the outcomes, individual patterns did not follow seizure outcome changes, showing that multiple factors were important for long–term HRQOL.

• The authors performed this prospective cohort study where patients underwent presurgical work-up during 1995–1998 completed the Short-Form Health Survey (SF-36) and the Hospital Anxiety and Depression scale (HAD) at baseline, and 2 and 14 years after resective surgery or presurgical evaluation (nonoperated patients).
• They compared SF-36 scores to a normative population.
• They calculated proportions of patients reaching HRQOL changes of minimum clinically important difference (MCID).

• Operated patients scored equal to or better than the normative sample on all SF-36 domains except Social Functioning and Mental Health at 14-year follow-up.
• As per the results, physical component summary (PCS) was better and mental component summary (MCS) was worse than for the normative sample.
• Compared to the normative sample, nonoperated patients scored worse on 5 of 8 domains, and on PCS and MCS.
• From 2 to 14 years, change in seizure status did not influence PCS or MCS means.
• The authors observed improvement reaching MCID from baseline to long-term in 50% (PCS) and 47% (MCS) of operated and in 33% (PCS) and 38% (MCS) of nonoperated patients.
• They noted worsening in 18% (PCS) and 22% (MCS) of operated and in 38% (PCS) and 38% (MCS) of nonoperated patients.
• Differences were nonsignificant between groups .
• Between groups, HAD scores did not differ and the numbers of possible or probable cases were low.
• In operated seizure-free patients, patient satisfaction with surgery was higher.
• In all operated patients, only 5% considered surgery not to be overall beneficial.