Abstracts

Rationale: Epilepsy is a common neurological disease that can affect people at any age of life, known to impact quality of life (QOL). However, the variations in QOL across age groups has not been investigated. It is postulated that developing a chronic disease, such as epilepsy, would have a significantly different effect on pediatric-aged patients, as compared to adults. The purpose of this research is to investigate the contrast between pediatric and adult-onset epilepsy. By understanding this difference, better individualized support can be provided.


Methods: The Mayo Clinic Arizona database of 568 epilepsy patients admitted to the Epilepsy Monitoring Unit who underwent neuropsychological testing from 2008 to 2019 was queried. Those diagnosed with epilepsy before the age of 26 were designated as pediatric onset (n=334), those after the age of 26 populate the adult-onset group (n=234). Administered as part of the neuropsychological testing, the Quality of Life in Epilepsy Inventory (QOLIE-31) which is a self-reported rating assessing patient’s emotional wellbeing, social function, energy, cognitive function, seizure worry, medication effect, and overall QOL was reviewed. Data from this survey was analyzed to determine how a pediatric diagnosis of epilepsy affects one's QOL compared to an adult diagnosis.


Results: The average disease onset age for the pediatric group is 13 and the adult-onset group 48. The pediatric onset population was 53.3% female and adult onset is 53.8% male. Three of the seven metrics of the QOLIE-31 were found to be statistically significantly different when comparing pediatric onset and adult groups, including social functioning, emotional wellbeing, and seizure worry. Pediatric onset patients found their diagnosis to have more of an impact on their social life than adult onset (T score mean 42.4 vs 45, p 0.030). Pediatric onset patients also reported a poorer emotional wellbeing with a mean T score of 46.7 in pediatric group and 50 in the adult-onset group (p 0.008). Finally, pediatric onset patients overall reported being more worried about their seizures as compared to the adults diagnosed with epilepsy (T score mean 43.9 vs 46.7, p 0.04). While these specific areas were found to be statistically different between groups, overall QOLIE scores were not found to be different (mean 42.8 vs 45, p 0.058). When patients were directly asked to rate their overall QOL, there also was not a statistically significant difference (mean 46 vs 47.4, p 0.291).


Conclusions: This study demonstrates that the age at which an epilepsy diagnosis is made has a significantly different impact on the QOL of patients. While our pediatric epileptic patients' overall QOL was not found to be statistically different, there are specific areas of concern unique to younger patients including social functioning, emotional wellbeing and worries surrounding their seizures. It is particularly important to understand the age of epilepsy diagnosis to individualize the support and counseling provided over the course of their care.


Funding: None