Abstracts

African American adults experience up to 3 times greater prevalence of epilepsy than whites, and racial disparities in the treatment of epilepsy (e.g., AED use, epilepsy surgery) are noted. However, little is known about quality of life in minority patients with epilepsy and other seizure disorders (e.g., psychogenic nonepileptic seizures, PNES). This study examines quality of life in black patients with recurrent seizures vis-[agrave]-vis white patients., We collected quality of life data (Quality of Life in Epilepsy-89, QOLIE-89; Profile of Mood States, POMS; Adverse Events Profile) on patients admitted to an epilepsy monitoring unit (EMU). Demographic characteristics/medical history were collected through medical record review/self-reports. The diagnosis of epilepsy vs other seizures was based on the results of prolonged video/EEG monitoring. We analyzed patients with all types of seizures and then replicated the analysis on the epilepsy subsample. We compared blacks and whites on medical characteristics and QOL using Chi-square tests for categorical variables and t-tests/F-tests for continuous variables., We had race information for 215 (72%) patients; 183 (85.1%) patients were white, 26 (12.1%) black, and 6 (2.9%) other race. 80 patients, 68 (37%) white and 12 (46%) black (p=0.256), received a definite diagnosis of epilepsy; others had possible epilepsy, PNES, possible PNES, or other diagnosis. The results show no significant differences between blacks and whites except 1) for all seizure patients, more prevalent history of head injury among blacks (p=0.013) and higher average score on POMS-fatigue/inertia among whites (p=0.018); and 2) for epilepsy subsample, higher average age of seizure onset for blacks (p=0.016). Close to significance was the greater prevalence of family history of epilepsy among blacks than whites. Although not significant statistically, the prevalence of epilepsy diagnosis was higher and QOLIE-89 overall score was lower for blacks., Racial differences in outcomes may not show in our data, which are limited by the small sample size. However, the lack of the differences may be due to the study setting, EMU, where black and white patients may be receiving similar treatment and, thus, show similar outcomes. Other healthcare settings should be examined because epilepsy treatment and outcomes could be different there. The higher percentage of medication-resistant seizure patients among blacks than whites suggests that the clinical management is not as effective in blacks; the reasons may include noncompliance or poor provider-patient communication. Blacks may also be less likely to be referred for specialized treatment, which could improve their outcomes.,