Abstracts

Rationale: Quality of life for persons with epilepsy may depend not only on aspects of the disease itself, but also on efficacy and side effects of treatment and the presence of comorbid conditions including depression and somnolence, which may be associated with the disease and/or its treatment. To assess and track the effects of comorbid conditions on quality of life, epilepsy patients at the University of Toledo Neurology Clinic were asked to complete short questionnaires regarding sleepiness, depression and quality of life, in addition to personal health information required for patient care.Methods: After IRB approval, we performed a retrospective chart review of patients with epilepsy who presented to a university-based adult epilepsy clinic between February 2005 and December 2006. Data collected at the time of the clinic visit included information on demographics, seizure type and frequency, medications, comorbid conditions, depression (Patient Health Questionnaire [PHQ] 9), daytime sleepiness (Epworth Sleepiness Scale [ESS]), and health-related quality of life in epilepsy (QOLIE 10). Statistical analysis included Spearman’s correlation tests, and regression analysis to identify predictors of quality of life in epilepsy. Results: A total of 146 patient records (63 male and 83 female) were reviewed. Mean age of the patients was 41 yrs (SD=16), and the majority had partial seizures (61%) followed by generalized seizures (25%). Median age at onset was 18 yrs, and in about 7%, seizures started at age ≤ 1 yr. Median monthly seizure frequency in the sample was 3.5 (range: 1 to 150). Median quality of life score was 17 (range 6 to 47) and a linear correlation was noted indicating decreased quality of life with increases in depression (r=0.641, p < 0.001) and daytime sleepiness scores (r=0.33, p < 0.01). Number of comorbid conditions trended toward a negative correlation with quality of life. A trend for correlation with seizure frequency was also noted (r=0.23, p < 0.09). Age-adjusted regression models confirmed the ability of depression (R²=40%) and daytime sleepiness (R²=12%) to predict quality of life. About 7% of patients were not on any AED prior to their first clinic visit, and 15% were on 3 or more AEDs.Conclusions: Health-related quality of life in patients with epilepsy negatively correlates with levels of depression and daytime sleepiness. Effective treatment strategies to address comorbidities may improve the overall health-related quality of life in persons with epilepsy.