Psychosocial effects and evaluation of the health-related quality of life in patients suffering from well-controlled epilepsy

Papapetropoulos, Spiridon; Polychronopoulos, Panagiotis; Corcondilas, Mihail; Argyriou, Konstantinos; Heras, P.

doi:10.1007/s00415-004-0313-7

Cited by 21 publications

(14 citation statements)

References 6 publications

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“…2,12 PSE impairs self-reported vitality and physical and social functioning. 13 We used a population-based register in a multiethnic area of London, including hospital and community diagnoses of first stroke, to investigate the epidemiology and associations of PSE over 12 years, focusing on long-term rates and predictors of epilepsy.…”

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confidence: 99%

Incidence and Associations of Poststroke Epilepsy

Graham

Crichton

Koutroumanidis

et al. 2013

Stroke

179

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C erebrovascular disease is the most commonly identified cause of acute symptomatic seizures and secondary epilepsy in adults, underlying approximately 11% of epilepsy diagnoses. 1 The incidence and associations of poststroke epilepsy (PSE) are not well-established; many previous studies have investigated seizure episodes, rather than epilepsy diagnoses, with uncertainty frequently arising from varying definitions of seizure timing, selective recruitment, and short follow-up. [2][3][4][5] Hemorrhagic strokes, cortical lesions, and large lesions are most consistently associated with poststroke seizures, 6 defined as early or late, based on timing and differing pathophysiology.7-10 A wide range (2% to 67%) of patients has been reported for the risk of early or late seizures after ischemic stroke, 11 whereas intracerebral and subarachnoid hemorrhages have been associated with a range of between 8% and 15% over varying durations of follow-up. 6 There is insufficient evidence to reliably predict those who will have development of PSE and would benefit from prophylactic antiepileptic treatment. Of those with a single seizure, approximately half were observed to have progression to epilepsy in a well-designed study with a maximum follow-up of 6.5 years.3 Associations have been suggested with deep infarctions extending to subcortical structures and late onset of first seizure after ischemic stroke.2,12 PSE impairs self-reported vitality and physical and social functioning. 13 We used a population-based register in a multiethnic area of London, including hospital and community diagnoses of first stroke, to investigate the epidemiology and associations of PSE over 12 years, focusing on long-term rates and predictors of epilepsy. Methods Study PopulationStroke subjects were recruited from the South London Stroke Register, an ongoing longitudinal register of first-ever strokes in subjects of all ages in a multiethnic inner-city population of 271 817.14 Background and Purpose-To describe the epidemiology and associations of poststroke epilepsy (PSE) because there is limited evidence to inform clinicians and guide future research. Methods-Data were collected from the population-based South London Stroke Register of first strokes in a multiethnic innercity population with a maximum follow-up of 12 years. Self-completed forms and interviews notified study organizers of epilepsy diagnosis. Kaplan-Meier methods and Cox models were used to assess associations with sociodemographic factors, clinical features, stroke subtype, and severity markers. Results-Three thousand three-hundred ten patients with no history of epilepsy presented with first stroke between 1995 and 2007, with a mean follow-up of 3.8 years. Two-hundred thirteen subjects (6.4%) had development of PSE. PSE incidence at 3 months and 1, 5, and 10 years were estimated at 1.5%, 3.5%, 9.0%, and 12.4%, respectively. Sex, ethnicity, and socioeconomic status were not associations, but markers of cortical location, including dysphasia, visual neglect, and field defect, ...

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confidence: 99%

Incidence and Associations of Poststroke Epilepsy

Graham

Crichton

Koutroumanidis

et al. 2013

Stroke

179

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“…Most studies of QoL in seizure-free patients, suggest normal or nearnormal functioning in many aspects of life [25,27,28,58]. Some more recent studies though, have found an impaired QoL (decline in overall QoL, in social and physical function, in symptoms of depression, health concerns and low self-esteem) even in seizure-free patients, and notably, to a higher degree that would 'normally' be expected [2,3,25,26,39]. These unexpected findings show that QoL in patients with epilepsy is determined by more than seizure control and alterations of consciousness [53].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Alterations in Consciousness on Quality of Life (QoL) in Epilepsy: Searching for Evidence

Charidimou

Selai

2011

Behavioural Neurology

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Abstract. The impact of epilepsy on Quality of Life (QoL) is well-documented. The ability of epileptic seizures to alter the conscious states of patients is also well established. Although there is much research on the QoL of people with epilepsy, few researchers have looked specifically at the effect of sudden, unanticipated alterations of consciousness on QoL. This lack of systematic studies of consciousness alterations and QoL in epilepsy limits our ability to shed light on this interrelation. In this article, with these limitations in mind, we focus on studies of newer AEDs. We review the evidence as to whether a significant reduction (typically more than 50%) in seizures that induce alterations of consciousness, as a result of switching to one of the newer AEDs, leads to improvements in QoL. We draw on this literature to speculate on the relationship between ictal consciousness alterations and poor QoL in epilepsy, to identify contributory and confounding factors and to highlight implications for future research. We suggest that an understanding of how factors associated with consciousness impairment affect QoL could help the treatment and management of these patients.

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“…Klinik nöbet özelliklerinin, antiepileptik ilaçlar hastalık süresi, sosyoekonomik durum, eğitim düzeyi yaşam kalitesi üzerine etkileri olduğu gösterilmiştir. [2,10,14] Hastalarımıza diğer toplumlara göre daha iyi aile desteği sağlanması, sosyoekonomik durumlarının daha az etkilenmesi ile ilişkili olabilir. Toplumumuz gibi eğitim düzeyinin düşük olduğu ülkelerde epilepsi hastalarında eğitim düzeyi ile YK arasında bir ilişki de saptanamamasına neden olabilir.…”

Section: Discussionunclassified

“…Özelikle nöbet sıklığının SF36'nın ağrı, fiziksel fonksiyon, mental sağlık alt ölçeklerini belirgin etkilendiği belirtilmektedir. [14] Ancak çalışmamızda SF-36'nın hiçbir alt ölçe-ği ile nöbet sıklığı arasında bir ilişki saptanmamıştır.…”

Section: Discussionunclassified

Surgical Treatment of Temporal Lobe Epilepsy Before and After Depression, Anxiety and Quality of Life Evaluation

Capraz¹,

Bilir²,

Erdem³

2011

Epilepsi

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ÖzetAmaç: Depresyon ve anksiyete dirençli temporal lob epilepsisinde (TLE) en sık izlenen psikiyatrik hastalıklardır. Bu çalışmada, dirençli temporal lob epilepsili olgularda anterior temporal lobektomi (ATL) öncesi ve sonrası depresyon, anksiyete ve yaşam kalitesi (YK) değerlendirildi. Gereç ve Yöntem:Çalışmamızda dirençli TLE olan 23 olgu prospektif olarak incelendi. Olguların klinik nöbet özellikleri, temporal lob lokalizasyonu, nöbet sıklığı, eğitim düzeyleri, sosyoekonomik durumları, antiepileptik ilaçları (AEİ), kraniyal manyetik rezonans görüntülemeleri ve patoloji sonuçları incelendi. Cerrahi öncesi ve cerrahiden sonra standart aralıklarla Beck depresyon envanteri (BDE), Beck anksiyete envanteri (BAE) ve Short Form 36 (SF-36) ölçekleri uygulandı. Bulgular: Çalışmamızda cerrahi tedavi öncesi depresyon ve anksiyete oranı %43.5 olarak bulundu. Olgularda depresyon ve anksiyetenin, demografik ve klinik özellikler açısından sadece nöbet sıklığı ile ilişkili olduğu saptandı. Nöbet sıklığı arttıkça depresyon ve anksiyete oranı da artmaktadır (sırası ile p<0.001 ve p=0.012). ATL sonrası depresyon ve anksiyetenin belirgin olarak düzeldiği izlendi. Bu düzelme cerrahi tedavi sonrası nöbetsizlik halini sağlamakla doğrudan bağlantılı idi (p<0.001). SF-36'nın alt ölçeklerinin tümünde cerrahi tedavi sonrası belirgin düzelme izlendi.Sonuç: Bu seride titizlikle seçilmiş dirençli TLE olgularında ATL'nin sadece epileptik nöbetlerin düzelmesini değil aynı zamanda psikopatolojinin de düzelmesini sağladığı görülmüştür. Cerrahi tedavi sonrası nöbetsizlik hali, depresyon, anksiyete ve YK'da düzelmenin en güçlü prediktörüdür.Anahtar sözcükler: Anterior temporal lobektomi; temporal lob epilepsisi; yaşam kalitesi. SummaryObjectives: Depression and anxiety are the most common psychiatric disorders in patients with drug resistant temporal lobe epilepsy. This study evaluated depression, anxiety and quality of life in patients with temporal lobe epilepsy before and after ATL.Methods: This prospective study was performed in 23 patient with resistant temporal lobe epilepsy. Clinical seizure characteristics, temporal lobe localization, seizure frequency, educational and socioeconomic status, antiepileptic medication, cranial MRI and pathology of cases were evaluated. BDE, BAI and SF-36 scales administered before and after ATL with standard interval. Results:We found a rate of 43.5% for depression and anxiety before surgical treatment. Depression and anxiety were found to be related only seziure frequency in terms of clinical and demographic features. The rate of depression and anxiety increased with increased frequency of seizures (p<0.001 and p=0.012 respectively). Depression and anxiety improved markedly following ATL in our cases. This improvement is directly associated with attaining a seizure-free state following surgical treatment (p<0.001). We found a marked improvement in all subscales of SF 36. Conclusion:We found in this series that ATL can benefit carefully-chosen drug resistant TLE cases both with an improvement in epileptic s...

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Psychosocial effects and evaluation of the health-related quality of life in patients suffering from well-controlled epilepsy

Abstract: Despite the fact that we studied a relatively small sample of patients with mild epilepsy, our results showed that their HRQOL was obviously affected, while their psychological health remained nearly unaffected.

Cited by 21 publications

References 6 publications

Incidence and Associations of Poststroke Epilepsy

Incidence and Associations of Poststroke Epilepsy

The Effect of Alterations in Consciousness on Quality of Life (QoL) in Epilepsy: Searching for Evidence

Surgical Treatment of Temporal Lobe Epilepsy Before and After Depression, Anxiety and Quality of Life Evaluation

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