Abstracts

Rationale: The goal of antiepileptic drug (AED) therapy is seizure freedom with no AED intolerable side effects, such that patients experience optimal quality of life (QOL). The purpose of the current study was to: 1) compare QOL in children with new-onset epilepsy to both a normative healthy population, as well as another sample of children with epilepsy and; 2) assess the impact of AED side effects on QOL.Methods: Participants included 37 children with new-onset epilepsy (Mean age = 7.2 years, 38% female, 57% Caucasian) and their caregivers. Sixty-five percent of children were diagnosed with partial epilepsy and 35% with generalized epilepsy, with 54% on carbamazepine and 46% on valproic acid. Parents completed a generic (Pediatric Quality of Life Inventory: PedsQL) and epilepsy-specific (American Quality of Life in Childhood Epilepsy Questionnaire: USQOLCE) quality of life questionnaire, and the Cincinnati Antiepileptic Drug Side Effect Scale (CASE) one month after initiating AED therapy.Results: Relative to healthy controls, patients with new-onset epilepsy had poorer Emotional (z = -2.3; p < .05), Social (z = -4.7; p < .0001), and School functioning (z = -5.3, p < .0001) but similar Physical functioning. Relative to an outpatient validation sample of children with epilepsy (Sabaz et al., Epilepsy Behav. 2003 Dec;4(6):680-91), our sample had better Energy/Fatigue (z = 5.4, p < .0001), Self-Esteem (z = 2.0, p < .05), Social Activities (z = 2.6, p < .01), and Overall Quality of Life (z = 3.2, p < .001). The relations between QOL and AED side effects were in the expected direction, with more severe AED side effects being associated with poorer QOL. Specifically, side effects were related to Physical (r = -.56; p < .0001), School (r = -.44, p < .01), Psychosocial (r = -.35, p < .05), and Total functioning (r = -.50, p < .01) on the PedsQL, and Depression (r = -.51, p < .01) and General Health (r = -.45, p < .01) on the USQOLCE.Conclusions: Children with new-onset epilepsy have impaired QOL on several domains of functioning compared to healthy children; however, their QOL is similar or better than children with epilepsy in Sabaz’s validation sample. More severe AED side effects were inversely related to QOL. In order to maximize QOL, healthcare professionals should focus on reducing seizures and minimizing AED side effects. Funded by the Center for the Promotion of Adherence and Self-Management, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center