Gender characteristics of social adaptation in surgery of drug-resistant temporal lobe epilepsy

Aim. To investigate the gender-specific social and demographic characteristics of neurosurgical patients with drug-resistant epilepsy.

Materials and methods. The study design was single-center, non-randomized, retrospective, in parallel groups. It was conducted at A.L. Polenov Neurosurgical Institute - branch of the V.A. Almazov National Medical Research Centre, in the department of functional neurosurgery in 2022-2023.

The study is part of the state assignment commissioned by the Government of the Ministry of Health of Russia (topic No. 123021000127-7 “Development of a new neurorehabilitation procedure for patients after surgical treatment for drug-resistant epilepsy”).

The object of the study were neurosurgical patients with drug-resistant epilepsy. The subject of the study was gender-specific socio-demographic indicators.

The study is based on the results of the examination and treatment of 100 patients with drug-resistant epilepsy after neurosurgical treatment at A.L. Polenov Neurosurgical Institute. There were 2 heterogeneous groups: group 1 - male, group 2 - female. Social functioning was assessed by social activity. Indicators of social functioning were educational level, employment, and disability group. The analysis of the statistical data obtained during the study was done using SPSS 12.

Results. Group 1 comprised 53 (53 %) men and Group 2 comprised 47 (47 %) women. The age of the cohort ranged from 18 to 43 years, with a mean of 29.65 ± 6.35 years. The average duration of disease before surgery was 18.79 ± 8.64 years.

The educational level in the cohort was characterized by the prevalence of vocational education - 42 % versus secondary education - 25 % and higher education - 33 %. In group 1, patients with secondary and specialized secondary education predominated, while in group 2 about half of the patients had higher education. There were twice as many unemployed people in the cohort as employed - 62 % and 31 % respectively and 5 % were studying.

The number of patients with disabilities was 41 %, without disabilities - 59 %, in group 1 and group 2 patients without disabilities predominated.

Conclusion. No gender-specific differences in social functioning were found in the long-term course of epilepsy. The long-term course of the disease has a negative impact on the indicators of social functioning of people with epilepsy in the preoperative phase. The cohort of the neurosurgical profile with pharmacoresistant epilepsy is characterized by problems of social adaptation: two thirds of them are not employed, a quarter of patients have only a high school diploma and no special education, 40 % have a disability.

It is necessary to actively inform doctors and patients about the existing possibilities of surgical treatment of epilepsy in order to achieve a wider application of modern methods of epilepsy neurosurgery and early referral to surgical care, thus improving the effectiveness of treatment.

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