Outcomes after acute inpatient rehabilitation following epilepsy surgery: A case series

Objective: To describe functional outcomes following discharge from an acute inpatient rehabilitation facility (IRF) in patients following epilepsy surgery, comparing laser interstitial thermal therapy (LITT) versus surgical resection for epilepsy. Design: Retrospective case series. Setting: Academic tertiary hospital. Participants: Eight patients who received LITT (n = 3) or surgical resection (n = 5) for epilepsy. Interventions: Acute inpatient rehabilitation. Main Outcome Measures: Functional independence measure (FIM), seizure incidence, discharge destination. Level of Evidence: IV. Results: The epilepsy cohort demonstrated a FIM change of 38.88 (vs. national average 29.55), average length of stay (LOS) of 15.13 days (vs. 13.38 days), and LOS efficiency was 3.4 (vs. 2.68). No patients in the epilepsy cohort were discharged to acute care hospital compared to a national average of 9.82%. Eighty-seven percent in the epilepsy cohort discharged to home (vs. 77%) and 12.5% to skilled nursing facility (vs. 11.90%). Between the subset who received LITT and those who received surgical resection, there was no statistically significant change in mean total FIM change (43.7 vs. 36), FIM efficiency (5.3 vs. 2.2), or FIM change in subset measures of memory (0.5 vs. 0.25) or problem solving (0 vs. 0.8). There was no statistical significance between groups in adverse events, including seizure. Conclusions: Outcome measures in this population appear to be consistent with national outcome measures for other IRF diagnoses. This suggests that acute inpatient rehabilitation should be considered after patients undergo surgical intervention for epilepsy. However, a larger sample size and controlled studies are necessary before generalizations can be made. In addition, no statistically significant functional difference was seen between patients who underwent LITT or surgical resection.