PREDICTORS OF POST-VNS QUALITY OF LIFE IN PEDIATRIC EPILEPSY AND THE EFFECT OF MULTIPLE HANDICAPS ON QUALITY OF LIFE OUTCOME
Abstract number :
2.188
Submission category :
Year :
2003
Submission ID :
1786
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Elisabeth M.S. Sherman, Mary B. Connolly, Daniel J. Slick, Paul Steinbok, Kim Eyrl, Cathy Massey, Kevin Farrell Psychology, B.C.[apos]s Children[apos]s Hospital, Vancouver, BC, Canada; Neurology, B.C.[apos]s Children[apos]s Hospital and University of Brit
In the development of selection criteria for VNS, it is important to consider the potential for improved quality of life (QOL) in addition to improved seizure control. The goal of this study was to identify predictor variables associated with improved quality of life following VNS and to determine whether children with multiple handicaps experienced as much improvement in QOL as other children.
Patients were 32 children (18 boys, 14 girls; mean age = 12.5 years, SD = 4.0) with intractable seizures treated with VNS between 1999 and 2003 at a tertiary care epilepsy centre. Three patients had prior epilepsy surgery and 13 had received the ketogenic diet. All were on multiple AEDs at baseline (median = 2). Fifteen of the children were non-verbal and had multiple handicaps (defined as severe to profound delays in mental development and severe motor or sensory handicaps). Testing was performed at baseline, 6 months and 12 months following VNS. All children were administered measures of adaptive behaviour (SIB-R), intelligence (WISC-III), psychopathology (CBCL) and attentional functioning (ADHD RS-IV). Parents of all children also completed a questionnaire of QOL (Impact of Child Neurologic Handicap Scale), which yielded measures of epilepsy-specific and global QOL.
None of the predictor variables measuring developmental, intellectual, behavioral or attentional impairment emerged as significant predictors of post-VNS QOL. Children with multiple handicaps were as likely as other children to experience improved quality of life following VNS. Contrary to expectation, children with multiple handicaps were rated as having slightly better global QOL at baseline than non-handicapped children (p [lt] .05). Following VNS, children with multiple handicaps also demonstrated larger improvements in epilepsy-related quality of life than non-handicapped children (p [lt] .03). Neither epilepsy-related nor global QOL were related to seizure outcome.
These findings indicate that improvements in QOL after VNS are not related to the severity of developmental, intellectual, behavioral or attentional impairments and that children with multiple handicaps are just as likely to experience improved quality of life after VNS as are other children.
[Supported by: British Columbia Medical Services Foundation/Vancouver Foundation]