Quality of life in patients with idiopathic, generalized epilepsy

The quality of life (QOL) in patients with idiopathic, generalized epilepsy (IGE) was assessed in 48 patients using the Quality of Life in Epilepsy inventory (QOLIE). Eleven recently diagnosed IGE patients (short-terms) were tested at 0 and 4 weeks, and at 6 months following initial diagnosis and treatment with sodium valproate. These patients were compared to 18 IGE patients who had been taking valproate for more than 1 year (long-terms) and to 19 normal controls. Both groups of IGE patients also were administered the A-B Neurotoxicity Scale and Liverpool Seizure Severity Scale. Recently diagnosed patients scored significantly lower than controls and long-terms on the following QOLIE subscales: work/driving/social function, health discouragement, seizure worry, medication effects, change in health, and overall health. Only with regard to the role limitation-physical subscale did both IGE groups score significantly more poorly than controls. The overall QOL score was significantly different among groups, with the controls scoring highest and the short-terms lowest. Short-terms reported significantly less seizure-associated distress on the Seizure Severity Scale at 4 weeks as compared to the initial test at 0 weeks. This effect was evident for both perceived control of major seizures and severity of postictal events. Seventy percent of short-terms were seizure-free by 4 weeks following initial diagnosis and treatment. The QOL was inversely correlated with both seizure severity and neurotoxicity scores. Taken together, these data indicate that QOL is significantly poorer in recently diagnosed patients than in patients with long-term epilepsy. Moreover, on most indices of QOL, long-term patients did not differ significantly from normal controls, indicating that the postdiagnosis decline in QOL is transient. These findings suggest that QOL in patients with IGE, changes throughout the course of the illness, and that following treatment with valproate, successful seizure control and restored QOL is possible.

Key words: Idiopathic epilepsy, Quality of life, Valproate, Neurotoxicity scale, Seizure severity scale, Quality of life inventory

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