Preview

Epilepsy and paroxysmal conditions

Advanced search

Patients with resistant focal epilepsy: what affects the quality of life?

https://doi.org/10.17749/2077-8333.2019.11.3.233-243

Full Text:

Abstract

The aim is to assess the impact of resistant focal epilepsy on the quality of patients' life.

Materials and methods. Prospective, comparative, observational study conducted under conditions of real clinical practice. Inclusion criteria: age over 18 years; the presence of two or more epileptic seizures in history; a long history of treatment-resistant focal epileptic seizures; current AED therapy. Exclusion criteria: history of non-epileptic seizures of any etiology; inability to perform an MRI and/or EEG. The design included two patient visits, the second 3-12 months after the first ("primary" and "repeated" examinations). The examination included the medical history, analysis of seizure diary, clinical and neurological examination, routine EEG and/or EEG video monitoring, brain MRI, and laboratory tests. During the initial and repeated visits, the patients were asked to answer the QOLIE-31, NHS3, HADS questionnaires. The patients were also asked to give their own subjective assessment of their physical and psychological state, treatment results, side effects, social situation, and the quality of life. All patients had a follow-up history of at least one year.

Results. In total, 120 patients with current or past treatment-resistant epileptic seizures were examined (53 men and 67 women aged 18 to 77 years). At the time of the re-examination (under continuing AED therapy), seizures stopped in 50.8% of them. The number of seizure types decreased in 65.9% of people. The effect of resistant focal epilepsy on the patient's quality of life was determined.

Conclusion. The use of commonly accepted tests (QOLIE-31, HADS, etc.) in the "expertise" mode is incorrect, probably because these tests had been originally created for the "client" situation. A discrepancy was found between an objective improvement in the clinical picture as a result of successful treatment and a subjective "insignificant" improvement in the quality of life as per patients' assessments.

About the Authors

K. V. Firsov
Moscow Regional Research and Clinical Institute (MONIKI)
Russian Federation

MD, PhD, Neurologist,

61/2 Shchepkina Str., Moscow 129110



M. G. Amirhanyan
Moscow Regional Research and Clinical Institute (MONIKI)
Russian Federation

MD, Neurologist, 

61/2 Shchepkina Str., Moscow 129110



A. S. Kotov
Moscow Regional Research and Clinical Institute (MONIKI)
Russian Federation

MD, PhD, Professor & Head, Department of Neurology,

61/2 Shchepkina Str., Moscow 129110



References

1. WHOOL. Measuring Quality of Life. World Health Organization/1997. P.1. [Electronic resource] URL: https://www.who.int/mental_health/media/68.pdf. Accessed: 08.07.2019.

2. Zubets A.N., Tarba I.V. Kachestvo zhizni v Rossii. Finansy. 2013; 12: 68-70.

3. Health-Related Quality of Life (HRQOL) [Electronic resource] URL: https://www.cdc.gov/hrqol/concept.htm. Accessed: 08.07.2019.

4. Kotov A.S., Rudakova I.G., Morozova O.S. Factors reducing the overall assessment of health-related quality of life in patients with epilepsy. Neurological journal / Nevrologicheskii zhurnal (in Russ). 2011; 16 (1): 10-14.

5. Kotov S.V., Rudakova I.G., Morozova O.S. The Influence of modern antiepileptic drugs on the quality of life of patients with epilepsy. S.S. Korsakov Journal of Neurology and Psychiatry / Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova (in Russ). 2008; 3: 36.

6. Fisher R.S., Cross J.H., French J.A., Higurashi N., Hirsch E., Jansen F.E., Lagae L., Moshé S.L., Peltola J., Roulet Perez E., Scheffer I.E., Zuberi S.M. Operational classification of seizure types by the International League Against Epilepsy: Position Paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017; DOI: 10.1111/epi.13670.

7. Scheffer I. E., Berkovic S., Capovilla G., Connolly M. B., French J., Guilhoto L., Hirsch E., Jain S., Mathern G. W., Moshé S. L., Nordli D. R., Perucca E., Tomson T., Wiebe S., Zhang Y.-H., Zuberi S. M. ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017; DOI:10.1111/epi.13709 1-3.

8. Kotov A.S. Compliance in patients with epilepsy. S.S. Korsakov Journal of Neurology and Psychiatry / Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova (in Russ). 2010; 110 (11): 46-48.

9. Henning O., Alfstad K.A., Nakken K.O., Lossius M.I. A call for better information about epilepsy: The patients’ perspective-An online survey. Seizure. 2019 Apr 27; 69: 173-179. DOI: 10.1016/j.seizure.2019.04.015. PubMed PMID: 31054491.

10. Alshahrani A.M., Pathan A., Alruwais J.F., Alduhayshi A.M. Knowledge, attitude, and believes of epilepsy in local communities of Saudi Arabia. J Family Med Prim Care. 2019 Mar; 8 (3): 1065-1069. DOI: 10.4103/jfmpc.jfmpc_425_18. PubMed PMID: 31041252; PubMed Central PMCID: PMC6482760.

11. Kotov A.S. Anxiety in patients suffering from epilepsy. S.S. Korsakov Journal of Neurology and Psychiatry / Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova (in Russ). 2013; 113 (4-2): 41-44.

12. Rudenko A.M., Kotov A.S. Depressive disorders in patients with epilepsy. Moscow. 2009; 35 s. (in Russ).

13. Hingray C., McGonigal A., Kotwas I., Micoulaud-Franchi J.A. The Relationship Between Epilepsy and Anxiety Disorders. Curr Psychiatry Rep. 2019 Apr 29; 21 (6): 40. DOI: 10.1007/s11920-019-1029-9. Review. PubMed PMID: 31037466.

14. Cramer J.A., Perrine K., Devinsky O., Bryant-Comstock L., Meador K., Hermann B. Epilepsia. 1998; 39: 81-8.

15. Kotov A.S., Rudakova I.G., Morozova O.S. Factors reducing the overall assessment of health-related quality of life in patients with epilepsy. Neurological journal /Nevrologicheskii zhurnal (in Russ). 2011; 16 (1): 10-14.

16. Baranowski C.J. The quality of life of older adults with epilepsy: A systematic review. Seizure. 2018 Aug; 60: 190-197. DOI: 10.1016/j.seizure.2018.06.002. Epub 2018 Jun 4. Review. PubMed PMID: 30031296.

17. Riechmann J., Willems L.M., Boor R., Kieslich M., Knake S., Langner C., Neubauer B.A., Oberman B., Philippi H., Reese J.P., Rochel M., Schubert-Bast S., Seeger J., Seipelt P., Stephani U., Rosenow F., Hamer H.M., Strzelczyk A. Quality of life and correlating factors in children, adolescents with epilepsy, and their caregivers: A cross-sectional multicenter study from Germany. Seizure. 2019 Mar 29;69:92-98. DOI: 10.1016/j.seizure.2019.03.016. Epub 2019 Mar 29 PubMed PMID: 31004927.

18. Tanti M.J., Marson A.G., Chavredakis E, Jenkinson MD. The impact of epilepsy on the quality of life of patients with meningioma: A systematic review. Br J Neurosurg. 2016; 30 (1): 23-8. DOI: 10.3109/02688697.2015.1080215. Epub 2015 Sep 7. Review. PubMed PMID: 26982950.

19. Guilfoyle S.M., Mara C.A., Follansbee-Junger K., Smith A.W., Hater B., Modi A.C. Quality of life improves with integrated behavioral health services in pediatric new-onset epilepsy. Epilepsy Behav. 2019 May 8; 96: 57-60. DOI: 10.1016/j.yebeh.2019.04.017. Epub 2019 May 9. PubMed PMID: 31077941.

20. Petruzzi A., Rigamonti A., Finocchiaro C.Y., Borelli P., Lamperti E., Silvani A., Regazzoni R., Stanzani L., Salmaggi A. Psychological features and quality of life in 50 adult patients with epilepsy and their caregivers from the Lecco epilepsy center, Italy. Epilepsy Behav. 2017 Jun; 71 (Pt A): 13-16. DOI: 10.1016/j.yebeh.2017.03.024. Epub 2017 Apr 22. PubMed PMID: 28441636.

21. Riechmann J., Willems L.M., Boor R., Kieslich M., Knake S., Langner C., Neubauer B.A., Oberman B., Philippi H., Reese J.P., Rochel M., Schubert-Bast S., Seeger J., Seipelt P., Stephani U., Rosenow F., Hamer H.M., Strzelczyk A. Quality of life and correlating factors in children, adolescents with epilepsy, and their caregivers: A cross-sectional multicenter study from Germany. Seizure. 2019 Mar 29; 69: 92-98. DOI: 10.1016/j.seizure.2019.03.016. Epub 2019 Mar 29. PubMed PMID: 31004927.

22. Gaston T.E., Szaflarski M., Hansen B., Bebin E.M., Szaflarski J.P.; UAB CBD Program. Quality of life in adults enrolled in an open-label study of cannabidiol (CBD) for treatment-resistant epilepsy. Epilepsy Behav. 2019 Apr 15; 95: 10-17. DOI: 10.1016/j.yebeh.2019.03.035. Epub 2019 Apr 16. PubMed PMID: 31003195.


For citation:


Firsov K.V., Amirhanyan M.G., Kotov A.S. Patients with resistant focal epilepsy: what affects the quality of life? Epilepsy and paroxysmal conditions. 2019;11(3):233-243. (In Russ.) https://doi.org/10.17749/2077-8333.2019.11.3.233-243

Views: 22


ISSN 2077-8333 (Print)
ISSN 2311-4088 (Online)