Seizure reduction and quality of life improvements in people with epilepsy.
OBJECTIVE
Previous research suggests that seizure freedom may be necessary to improve health-related quality of life (HRQOL) for epilepsy surgery patients, but little is known regarding the seizure-frequency reduction needed to improve HRQOL among medically treated individuals.


METHODS
With data from 134 adults with refractory complex partial seizures participating in a randomized controlled antiepileptic drug (AED) trial, we compared the change in HRQOL across groups having different levels of change in seizure frequency: 100%, 75-99%, 50-74% reduction, and 0-50% increase or decrease. Changes over time within each seizure-reduction group also were assessed. HRQOL was measured by the QOLIE-31, QOLIE-89, and SF-36.


RESULTS
Subjects who became seizure free reported significantly more positive change than those who did not on the QOLIE-31 and QOLIE-89 overall scores, the QOLIE-89 mental health, physical health, and epilepsy-targeted composites, as well as the SF-36 mental health summary score. Changes over time in overall QOLIE-31 and QOLIE-89 scores were significantly more positive for subjects who achieved seizure freedom (i.e., 100% reduction in seizure frequency) than for those who did not. No significant change in QOLIE-31 and QOLIE-89 overall scores was observed for subjects who did not achieve seizure freedom.


CONCLUSIONS
In this study, HRQOL improvement occurred primarily among patients who achieved complete seizure freedom. Many AED trials use a 50% seizure-frequency reduction criterion as a trial end point, but measurable impacts of this degree of reduction in seizure frequency on HRQOL in this sample were not observed. These results further support striving for seizure freedom as an epilepsy care goal.
Birbeck
Gretchen L
GL
Department of Neurology, Michigan State University, Clinical Center, East Lansing, MI 48824-1313, USA. gretchen.birbeck@ht.msu.edu
Hays
Ron D
RD
Cui
Xinping
X
Vickrey
Barbara G
BG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use*; D001294:Attitude to Health; D002220:Carbamazepine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D010672:Phenytoin / Q000627:therapeutic use; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D020888:Vigabatrin / Q000627:therapeutic use
D000927:Anticonvulsants; D002220:Carbamazepine; D010672:Phenytoin; D020888:Vigabatrin