Abstracts

RATIONALE: The quality of life (QOL) of children following epilepsy surgery has received little attention in the literature. Previous paediatric studies exclusively evaluate the effect of seizure outcome on QOL without considering other important clinical variables. The aim of this study was to determine the factors that were predictive of improved QOL outcomes. A second aim was to provide further external validation of the psychometric properties of the Quality of Life in Childhood Epilepsy questionnaire. (QOLCE) (1).
METHODS: The study design was a retrospective cross-sectional analysis with the entry criteria being children (age 4 to 18 years) who had epilepsy surgery at Miami Children[ssquote]s Hospital greater than 12 months ago. Parents were asked to complete the QOLCE. Demographic variables included family income, ethnic origin, marital status and parental education level . Clinical factors included, for example, age at surgery, duration of epilepsy, cognitive ability, surgical site, pathology and outcome. Univariate analysis of these variables correlating with the total QOL scores and subscales was performed.
RESULTS: 55 children were enrolled, 28 male. The mean age at surgery was 8 years with a mean duration of epilepsy of 5.3 years. The post-operative outcomes were that 31 children were seizure free and 9 had a [gt]90% reduction. Univariate analysis of clinical variables revealed only seizure outcome as a significant factor in predicting total QOL score. Seizure freedom or a greater than 90% reduction in seizures post-epilepsy surgery explained 35% of the variance of the total QOL scores (p=0.001). There was no significant difference between the seizure free and [gt]90% seizure reduction groups. The QOL domains that surgery outcome significantly influenced were physical restrictions, energy/fatigue, perception of general health, social activities and other cognitive processes (p[lt]0.003). A longer duration of epilepsy prior to surgery did not have a negative effect on QOL scores. No other demographic or clinical factor exerted a significant effect.
CONCLUSIONS: Children who achieve a greater than 90% reduction in seizures following epilepsy surgery have a significantly higher QOL as measured by the QOLCE. No other clinical or demographic variables significantly influenced outcome. This study further validates the QOLCE as a specific instrument sensitive to the measurement of quality of life change following epilepsy surgical intervention.
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1. Sabaz M, Cairns DR, Lawson JA, Nheu N, Bleasel AF, Bye AME. Validation of a new quality of life measure for children with epilepsy. Epilepsia 2000;41(6):765-74.
: The aim of this presentation is to increase understanding of the effects of epilepsy surgery on a child[ssquote]s quality of life.
[Supported by: National Health and Medical Research Council (Australia) (grant number 209512).]