Epilepsia, 47(5):928–933, 2006 Blackwell Publishing, Inc. C  2006 International League Against Epilepsy Normalization of Quality of Life Three Years after Temporal Lobectomy: A Controlled Study ∗ †‡Mohamad A. Mikati, ‡§Youssef G. Comair, and ∗ ‡Amal Rahi ∗ Department of Pediatrics, †Department of Internal Medicine, Division of Neurology, ‡Adult and Pediatric Epilepsy Program, and §Department of Surgery, Division of Neurosurgery, American University of Beirut Medical Center, Beirut, Lebanon Summary: Purpose: The goal of epilepsy surgery is not merely to control previously intractable seizures, but also to improve quality of life (QOL). Our goals were to assess, in our Mid- dle Eastern population, the QOL of adults with temporal lobe epilepsy (TLE) 3 years after temporal lobectomy as compared with matched TLE patients who did not undergo surgery and with healthy individuals in the same community. Methods: Twenty consecutive TLE patients who underwent temporal lobectomy 3 years previously were matched in the fol- lowing variables: age, sex, seizure frequency, seizure duration, age at onset of epilepsy, duration of epilepsy, and number of medications, with 17 TLE patients who underwent the presurgi- cal evaluation and subsequent optimization of medical therapy but did not undergo surgery. They were also matched for age, sex, educational level, income, and residence with 20 healthy individuals. All groups were interviewed by using the ESI-55 questionnaire. Results: Compared with the nonsurgery group, QOL was sig- nificantly better in the surgery group (85% seizure free) in the well-being, functioning, and role-limitation domains. QOL was similar in the surgery and healthy control groups in all domains and scales. The nonsurgery group scored significantly lower than healthy controls in the functioning and role-limitation domains. Conclusions: Intractable TLE was associated with marked im- pairments in QOL despite continued attempts to optimize med- ical therapy. Three years after temporal lobectomy QOL in our patient population achieved levels similar to those of matched healthy individuals. To our knowledge, this is the first study to report normalization of QOL after temporal lobectomy, in any population. Key Words: QOL—temporal lobe epilepsy— Lobectomy. The first 2 years after epilepsy surgery are usually a time to recuperate from the surgery and to taper antiepileptic medications (AEDs). Thus major changes in quality of life (QOL) can be expected to occur in subsequent years as the patient takes advantage of his or her condition and adapts to it at home and at work (1–5). The real value of postsurgery QOL studies is, thus, eventually to identify changes in QOL that are sustained on a long-term basis after surgery and to determine whether QOL after epilepsy surgery is comparable to that of the normal “healthy” pop- ulation. To our knowledge, only one study has compared QOL of epilepsy surgery patients with that of healthy in- dividuals (6). In addition, adaptation after epilepsy surgery is likely to be population and culture dependent. The purpose of the present study was, thus, to investigate, in our Lebanese Accepted January 2, 2005. Address correspondence and reprint requests to Dr. M. Mikati at Adult and Pediatric Epilepsy Program, Department of Pediatrics, American University of Beirut, Beirut, Lebanon. E-mail: mamikati@aub.edu.lb. Office address: Department of Pediatrics, 6th floor, American Uni- versity of Beirut Medical Center, PO Box: 11-0236 Riad El Solh, 1107 2020, Beirut, Lebanon Middle Eastern population, the QOL of patients that had undergone temporal lobectomy 3 years previously as com- pared with epilepsy nonsurgery patients and with healthy individuals. METHODS The study population consisted of three groups. The surgery group included the first 20 adult epilepsy patients who underwent temporal lobe epilepsy surgery in our cen- ter when seen at their 3-year follow up. The nonsurgery group included 17 temporal lobe epilepsy patients who underwent long-term monitoring (LTM) as part of their presurgical evaluation during the same period, but who were ineligible for surgery. The healthy controls group in- cluded 20 healthy subjects with no chronic diseases. In the nonsurgery group, surgery was not performed for one or both of the following reasons: inability to localize a single epileptic focus, or the focus was located in an eloquent area of the brain where cognitive or motor impairments such as memory or speech deficits could result if the focus was resected. The two comparison groups were matched with the surgery group for age, sex, place of residence, educa- tional level, and income level. In addition, the two epilepsy 928