Abstracts

RATIONALE: Vagus nerve stimulator (VNS) is a novel treatment for medically intractable epilepsy which is effective as adjunctive treatment. However, VNS rarely results in total control of epilepsy. Thus, health-related quality of life (HRQOL), in addition to seizure control, is an appropriate outcome measure for patients implanted with VNS. This study examines HRQOL in children (and their families) implanted with VNS. We report baseline data on HRQOL prior to VNS implantation. METHODS: Twelve patients (aged 4-16 years) have been enrolled in this prospective research study; 5 males, 7 females. We report data on 4 questionnaires that assess HRQOL: 1. Child Health Questionnaire (CHQ) 2. Impact on Family Scale (IoF) 3. Hague Seizure Severity Scale (HSSS) 4. Functional Status II (FSII). RESULTS: Our patients are similar to published controls on measures of impact on family (IoF) and seizure severity (HSSS) but demonstrated poor HRQOL on CHQ and FSII. IoF scores, a measure of general impact on family functioning, were similar to the control group of children with chronic illness. Seizure severity (HSSS) was similar to a general epilepsy population studied by Carpay. Our patients scored significantly lower in 6/8 categories on the CHQ (p= < 0.006) than healthy children and than a control population of children with epilepsy. CHQ parental stress scores were significantly lower in the study group than in healthy children. Study patients FSII functional ability scores were much lower than both healthy and sick children. 100% of our population scored < 82 on the FSII whereas, 98.5% of healthy children and 69.3% of ill children scored above 82. CONCLUSIONS: Our study includes measures of family and child function since these combine to define HRQOL in children. The epilepsy in our patients was no worse than a general epilepsy population and high family stress as measured by CHQ did not adversely impact family function as measured by IoF. However, the study suggests our population is more physically impaired and broadly impacted by the epilepsy. We are now collecting data on the impact of VNS on these measures.