Abstracts

Objective: To determine if the QOLIE-10 is useful in differentiating pseudoseizure from epilepsy.
There is little data regarding the efficacy of the QOLIE in discriminating pseudoseizure from epilepsy. We hypothesized that psedudoseizure patients often overstate the impact of their disability on QOL and produce quantitatively different profiles from epilepsy patients. We explored differences in specific questions and total score.
METHODS: Participants were 27 adults (age range, 19 - 78) who were admitted to the inpatient University of Virginia Epilepsy. Data from QOLIE-10 questionnaires were obtained by retrospective chart review of questionnaires which are administered routinely to all patients admitted to the Unit. A total score was obtained on 17 participants (Epilepsy [underline] n [/underline] = 10; Pseudoseizure [underline] n [/underline] = 7), and individual questions were answered more frequently (e.g., all participants answered question 5).
RESULTS: QOLIE-10 Total Scores were not different between epilepsy ( [underline] m [/underline] = 28.90, [underline] SD [/underline] = 5.78) and pseudoseizure patients ( [underline] m [/underline] = 30.43, [underline] SD [/underline] = 8.06; [underline] p [/underline] = .65). Compared to the epilepsy group, the mean score was greater in the pseudoseizure group on question 5 ( [underline] m [/underline] = 2.81, [underline] SD [/underline] = 1.52 vs. [underline] m [/underline] = 4.1, [underline] SD [/underline] 0.87; [underline] p [/underline] = 0.02), and lower in the pseudoseizure group on question 9 ( [underline] m [/underline] = 3.59, [underline] SD [/underline] = 1.22 vs. [underline] m [/underline] = 2.40, [underline] SD [/underline] = 1.51; [underline] p [/underline] = 0.04). A prior diagnosis of an anxiety or depressive disorder was more than twice as likely in the pseudoseizure group and all pseudoseizure patients had such a diagnosis (X ² = 14.75, [underline] p [/underline] [lt] .01). The prevalence of psychiatric illness in the epilepsy group (23.5%, 4/17) was much lower than in the pseudoseizure group (100%, 7/7). Age was not predictive of QOLIE-10 Total Score by linear regression (P=0.46).
CONCLUSIONS: Pseudoseizure patients reported more work-related concern (question 5) while epilepsy patients reported more fear of having another seizure (question 9). This raises the possibility that the QOLIE-10 is useful in evaluation of pseudoseizures as well as epilepsy but a larger sample must be examined to determine its validity. Pseudoseizure patients may have more work-related concern because of preoccupation with somatic complaints; and less concern of having another seizure because pseudoseizures are less injurious.
[Supported by: Department of Neurology, University of Virginia Medical Center
Center for Organizational Development, University of Virginia Medical Center]