Abstracts

Rationale: Access to the adverse effects of AEDs in children depends solely on the narrative of the perception of behavioral changes by their caregivers, which makes it difficult to manage. The aim of this study is to evaluate the relation of AED adverse events in children with epilepsy  with burden of care on caregivers, child's behavior, and quality of life (QOL) using Liverpool Adverse Event Profile (LAEP) by proxy. LAEP is a likert-scale questionnaire developed by Baker et al. and it contains 19 items of the most common complaints of patients using AEDs1. It is worldwide used for the detection and quantification of adverse effects of all AEDs in mono- or polytherapy in adults. Methods: The study received ethical aproval from Institutional IRB. A cross-sectional sample survey performed at a tertiary university outpatient childhood epilepsy center in Brazil with 84 patients aged 2-19 yrs. and their caregivers who completed four screening instruments: LAEP, QOL (QVCE-50 by Souza Maia Filho et al., 2007), Strengths and Difficulties Questionnaire (SDQ) and Burden Interview (BI); 19 patients (11-18 yr.) also completed three self-reporting instruments (LAEP, QOLIE-AD-48, SDQ). All these questionnaires were valitaded into Portuguese in other previous studies. Results: Children with LAEP toxic scores (>45) of AEDs counted for 25% (n=21), being 61.9% (n=13) on polytherapy and 38.1% (n=8), monotherapy. Parent-reported LAEP was higher for patients in polytherapy (p=0.009), with more than one seizure type (p=0.005) and increased seizure frequency (r=0.311, p=0.002). On factor analysis only polytherapy was identified as an independent latent variable in parent-reported LAEP variation and no AED was individually identified as an independent factor. In children with LAEP toxic scores BI values were higher (p=0.028) in caregivers (fig. 1) as well their SDQ scores (p=0.003) (fig. 2) than in those without toxicity; lower QVCE-50 values (p < 0.001) were found in toxic group. There was strong correlation between caregiver and adolescent LAEP reports (r=0.751, p=0.010). Conclusions: Toxic LAEP AED levels are associated with poor mental health scores and low QOL measurements in children with epilepsy, along with high caregiver burden, mainly in those in polytherapy. LAEP may be used in children with epilepsy as an objective screening tool for psychic and health assessment.Reference.  1. Baker GA, Frances P, Middleton E, Jacoby A, Schaper GJ, Defalla B, et al. Initial development, reliability, and validity of patient-based adverse effects scale. Epilepsia 1994;35:s80. Funding: Brazilian agencies of research funding: CAPES, CNPq and FAPESP.