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Comparison of diagnostic yield of different MRI protocols and PET in relation to time an finance demands in patients with temporal epilepsy
FILÍPKOVÁ, Brigita
This Thesis called Comparison of diagnostic yield of different MRI protocols and PET in relation to time and finance demands in patients with temporal epilepsy deals with time and economic aspects of diagnostics of pharmacoresistant temporal epilepsies. Temporal epilepsies are the most frequent focal epilepsies (up to 85 %) and pharmacologic control is only successful in about 25 % cases. On the other hand it is the best type of epilepsy to be solved surgically. Timely and precise diagnostics enables a timely surgical intervention. The time and economic demands increase the same way as the demands for technical staff. The Thesis was aimed at finding a protocol advantageous in terms of both, time and cost saving, maintaining the diagnostic yield in comparison of two neuroimaging methods - functional (PET) and morphological (MR), where we also compared two protocols for brain examination - a standard one and a special epileptological one. Methodology: A retrospective study of 44 patients with clinically confirmed focal epilepsy examined by MR and PET, who underwent a microsurgical intervention and have been without fits since then. We compared the individual protocols on MR - standard (sequence T2/PD tse tra, FLAIR tra, T2* tra and T1 se sag) and epileptological (extended by 3DT1 ge, T2 tse fs cor and FLAIR cor) in terms of possible diagnostics (examination read by an experienced radiologist) and evaluated their time and cost demands. We also evaluated a PET examination, which is performed by one protocol, the same way. The results demonstrate the difference in examination time and costs between the standard and the epileptological protocols on MR and between the MR and PET methods. There are also results of reading MR and PET images and their correlates presented there. We may conclude that the epileptological protocol on MR cannot be substituted by a standard protocol. Time may be saved by better organization of work or by suitable adjustment of parameters of the individual sequences maintaining sufficient MR image quality. We are also convinced that both the methods, MR and PET are important for safe diagnosis. Cost saving is impossible in pre-operation diagnostics.
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Effects of surgery treatment of epilepsy on psychosocial condition of the patients.
ŠIŠKOVÁ, Lenka
The thesis "Effects of surgery treatment of epilepsy on psychosocial condition of the patients" deals with the disease which causes many social effects on the patients. The most frequent ones are limitations in the working life and mental problems. I am interested in the epilepsy issue and therefore I have selected this topic which continues the bachelor thesis written in 2008. The objective of my work was to determine effects of epileptosurgery on the work life and on the mental area. Two hypotheses were established which assumed that the surgical treatment improved the patient´s life both in the working and in the mental spheres. The hypotheses were tested by means of quantitative research; questionnaires were used for the collection of data and the respondents were adult patients, who underwent surgical treatment of epilepsy and have been in the care of the Center of Epilepsy Na Homolce in Prague, and patients in the care of neurology departments in České Budějovice and in Strakonice. The results have shown that the epileptosurgery failed to improve the lives of the patients in the working sphere and thus the first hypothesis was not confirmed. Many of the patients are still unemployed and they still find it difficult to find jobs. The offer of vacancies has not increased much after the surgery. Those who work often feel stress and anxiety as a result. Some patients even lost jobs after the surgery or their working positions do not correspond to the achieved qualification level, experience and potential. The improvement in the mental area has been confirmed and many of the patients no more suffer from mental problems they had before the surgery. In some of the respondents mental disorders diminished or disappeared entirely. They are more self-confident, more even-tempered and they need less professional help. In this area I see the effects of surgical treatment as very beneficial. The results of my thesis might be used in publications for the general public, as well as for professionals specializing in the field.
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