Abstracts

The subjective measure of quality of life is an important variable in evaluating patients with epileptic (ES) and nonepileptic seizures (NES). Despite the different origins of the seizures, NES patients face similar struggles as patients with epilepsy, including effects of antiepileptic medications and limitations on daily activities. Use of the QOLIE, an epilepsy-specific survey on quality of life, for patients with NES has been validated. One aspect of quality of life that is frequently overlooked in clinical studies is sexual function and satisfaction. Epileptic patients have higher rates of sexual dysfunction than the general population, but physicians rarely inquire about epileptic patients[rsquo] sexual activity. Less is known about sexual function in patients with NES. The objective of this study was to determine how quality of life and rates of sexual satisfaction and function compare between ES and NES patients. We sent surveys to 50 patients with NES and 50 age- and sex-matched patients with ES; all patients[rsquo] diagnoses were confirmed by vEEG monitoring. We used two standardized, previously validated psychiatric diagnostic instruments, the QOLIE-10 and the Arizona Sexual Experiences Scale (ASEX) The QOLIE includes 10 questions assessing the effects of seizures and AEDs on functioning and quality of life. The ASEX has five questions assessing sexual function and satisfaction. Data were analyzed using SPSS for Windows. 10 NES and 12 ES patients returned surveys. The NES and ES patients did not differ in age (p = 0.37) or gender (p = 0.89). NES patients were significantly less likely to report having a lot of energy (p = 0.03). They were significantly more likely to report being bothered by the mental effects of their antiepileptic drugs (AEDs) (p = 0.04), but not the physical effects (p = 0.55). NES patients also rated their quality of life significantly lower than ES patients (p = 0.02). In 3 of 5 categories rating sexual function, NES patients showed trends toward lower scores that nearly reached significance. They reported lower sex drive (p = 0.12), more difficulty becoming mentally aroused (p = 0.07), and more difficulty with physiological arousal (p = 0.08). They did not differ in ability to achieve or satisfaction with orgasm; these scores were extremely low in both groups. NES patients reported significantly lower quality of life and level of energy than ES patients. They were significantly more bothered by mental effects of AEDs, emphasizing the importance of discontinuing AEDs in patients with exclusively nonepileptic seizures. Though ES patients have high levels of sexual dysfunction, NES patients tended to rate their sexual function and satisfaction lower than ES patients. The impact of NES on sexuality should be further clarified with larger studies.