TEMPORAL LOBE EPILEPSYSocial Conditions and Rehabilitation after Surgery

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Abstract
A social investigation was performed of 74 patients with temporal lobe epilepsy resistant to medication, who underwent unilateral temporal lobectomy in 1960-1969. Patients were compared to their siblings and to the general population in Denmark. Comparatively many patients were born out of wedlock. The level of schooling achieved was lower than expected, and this was most pronounced in patients with an early onset of epilepsy. The number of patients who had received further education was also smaller than calculated. At the time of the operation all patients were socially incapacitated by their epilepsy; this was most pronounced in males, of whom 30% were institutionalized and 32% were receiving a disability pension; at follow-up the figures were 6% and 52%, respectively. Working capacity was markedly improved postoperatively, and at follow-up 39% were in full-time employment. Relief from seizures (or almost complete relief), normal intelligence, normal psychiatric status and operation before the age of 18 yr were factors which favorably influenced the postoperative working capacity. The majority of patients were unmarried or divorced, and few of the group had children. Their housing conditions were inferior to those of their siblings and of the general population. Parental social class distribution showed an excess in the highest and lowest social classes compared to the Danish population. Patients were subjected to downward social mobility, presumably caused by their illness, as their siblings displayed an upward mobility, which was most marked in the females.