Determinants of quality of life in patients with refractory focal epilepsy who were not eligible for surgery or who rejected surgery

► QOL in patients with refractory focal epilepsy who were not eligible for surgery or who rejected surgery has multiple determinants. ► QOL is explained in large part to depression and anxiety but not exclusively. ► Side effects of AEDs and employment were important predictors of QOL. ► Reevaluation of the epilepsy syndrome through presurgical evaluation may improve QOL regardless whether epilepsy surgery is possible. ► Balance among seizure control, the side effect of AEDs and the burden of depression must be kept in mind to optimize QOL.