CLINICAL OBSERVATIONS RELEVANT FOR OUTCOME IN MENTALLY DISABLED PEOPLE WITH INTRACTABLE SEIZURES INSTITUTIONALIZED IN AN EPILEPSY CENTRE
Abstract number :
2.038
Submission category :
Year :
2003
Submission ID :
2516
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
P.J. Simons, I.Y. Tan, P. Boon Onderzoek en Ontwikkeling, Epilepsy Centre Kempenhaeghe, Heeze, Noord-Brabant, Netherlands
Systematic clinical observation in mentally disabled people with epilepsy has not been well reported in the literature. A comprehensive clinical database of all patients institutionalised in a single department of Epilepsy Centre Kempenhaeghe was set up. We studied 18 patients (13 M, 5F), living in three different units of one department designed and equipped for treating moderately and severely mentally disabled people with intractable epilepsy.
to identify factors that influence treatment outcome.
We carefully reviewed historical medical files and recent ones for all relevant information concerning epilepsy. In addition, we interviewed individual patient[rsquo]s epilepsy-carers based on two questionnaires, one concerned with seizure severity (such as falls, injuries, incontinence, [hellip]. (National Hospital Seizure Severity Scale, NHS3) and one which addressed concerns about cure and care of epilepsy (such as seizure pattern and severity, treatment decisions, social impact [hellip]) (Glasgow Epilepsy Outcome Scale, GEOS, used in the abridged version GEOS-35).
Mean age was 42 years (range:28 - 58;SD 9.2). All but 2 patients were diagnosed with localization-related epilepsy. The mean GEOS score was 46.2 (range:18 - 76; SD 16.79), the mean NHS3-score was 23.9 (range:6 - 41; SD 11.58). There was a good correlation between NHS3- and GEOS-scores (r=0.706; p[lt]0.01). A strong correlation was found between age and the GEOS-score (r=0.745; p[lt]0.001). The total number of different antiepileptic drugs (AEDs) ever prescribed to patients correlated well with the age (r=0.604; p[lt]0,01) and with the GEOS-score (r=0.696; p[lt]0.01).
The correlations between the NHS3- and GEOS-scores show that the concerns about cure and care of epilepsy in our population strongly depend on seizure severity. Other factors become important with low seizure severity. The older the patients are, the better their epilepsy is controlled and the fewer the number of different AEDs they have been treated with. These clinical observations may contribute to identifying the factors influencing epilepsy outcome in this specific population.