American Board of Internal Medicine (ABIM) Certification Practice Exam

What intervention is most likely to improve quality of life in patients with refractory temporal lobe epilepsy?

1. Medication adjustment

2. Intensive therapy sessions

3. Surgical intervention

4. Biofeedback techniques

The correct answer is: Surgical intervention

Surgical intervention is recognized as a significant option for improving the quality of life in patients with refractory temporal lobe epilepsy, particularly when seizures are not controllable with medication and when they severely impact daily functioning. This type of epilepsy often arises from structural abnormalities in the temporal lobe, such as hippocampal sclerosis, which can be effectively addressed through surgical approaches like resective surgery. Patients who undergo surgery often experience a significant reduction in the frequency and severity of seizures, which directly contributes to enhanced quality of life. Improved control over seizures can lead to increased independence, better emotional and social functioning, and reduced need for ongoing medical therapy. In contrast, while medication adjustments and intensive therapy sessions can have benefits, these interventions may not provide the same level of improvement in seizure control as surgical options for refractory cases. Biofeedback techniques, although beneficial for some conditions, lack substantial evidence supporting their efficacy in managing refractory temporal lobe epilepsy specifically. Thus, surgical intervention stands out as the most likely approach to achieve a considerable enhancement in the quality of life for these patients.