Abstracts

Quality of life (QOL) in epilepsy in previous studies has not been dependant on severity of seizure disorder, or medication effects. We surveyed 90 consecutive patients to determine what their expectations were for epilepsy visits, and to evaluate the impact of several features of their illness on QOL.
We surveyed 90 epilepsy patients identified through clinic rosters at the University of Michigan epilepsy program. The patients were asked 9 multiple choice questions about their expectations and limitations, one open-ended question about their fears, and completed a QOLIE 10 questionnaire. Demographic information was collected both directly from patients and from their medical records. Seven epilepsy faculty were asked to predict the patient responses to multiple choice questions.
Average QOL was 2.5/5 in this group where 71% had at least monthly seizures. Most were not married and had no children 44% were unemployed. The majority were on a single AED. There was no correlation between QOL and gender, age or number of AEDs. The number of monthly seizures did not negatively correlate with QOL. QOL scores tended to improve with employment and marital status. Patients feared injuring self or others and losing independence most. The majority of patients refused to answer questions about driving. Consistent compliance with medications was reported by 70% of patients. Physicians were not able to predict a strong desire for improved employment and a very common avoidance of childbearing in our population.
Our population of refractory epilepsy patients has a relatively poor quality of life that does not depend on the apparent severity of their epilepsy. Issues such as vocational rehabilitation and fears about childbearing were not expected by epilepsy faculty. Patients are reluctant to discuss driving issues with their physicians. Patients[rsquo] level of fear about injury and even death are substantial. Efforts to improve QOL including vocational discussions and education about pregnancy may be helpful.