Introduction

Epilepsy surgery is an effective treatment for reducing or eliminating seizures in patients with medically intractable epilepsy. Seizure control can be expected in 60–80% of patients with temporal and 50–80% with extra-temporal lobe epilepsy. However, the evaluation of seizure outcome alone is not sufficient in the assessment of surgical effectiveness. The final goals of epilepsy surgery are to reduce the frequency and intensity of seizures without catastrophic complications as well as improvement in quality of life (QOL). Seizure cessation is correlated with improved QOL and seizure-free patients have the potential to realize a normal life. Epilepsy leads to more psychosocial problems compared to those without epilepsy, most notably anxiety, depression, and low self-esteem. Stigma of epilepsy has a major negative impact on QOL. Additionally, people with epilepsy are more likely to be unemployed or under-employed, have lower rates of marriage, and greater social isolation.

In this chapter, we will summarize the impact of epilepsy surgery on QOL including psychosocial life in temporal and extra-temporal lobe epilepsy. The long-term results in patients with temporal and extra-temporal lobe epilepsies will be discussed with respect to seizure outcome, antiepileptic medication (AED) use, employment, and QOL pre- and postoperatively.