Abstracts

Rationale: In order to evaluate various aspects of seizure impact on epilepsy patients there are several useful scales but none measure disability.Since patients can have episodic disability from seizures and from medication side effects we designed a new scale for measuring dysfunction related to seizures and seizure therapy for assessing epilepsy patients. Due to the episodic nature and other clinical similarities between migraines and seizures we developed a new scale SERDAS ( seizure related disability assessment scale) based on the validated migraine disability scale MIDAS (Migraine Disability Assessment Scale). To test the design, we compared the results on the SERDAS in two epilepsy populations, one of which is severely disabled (patients admitted to an epilepsy monitoring unit for presurgical evaluation or classification) and the other of which is less severely disabled (patients from an outpatient epilepsy clinic.) Methods: SERDAS is a six-item questionnaire designed to measure seizure severity based on dysfunction related to number of events, as well as to medication side effects and other seizure-related dysfunction. The last question will not contribute to the total points on the scale, but will give the clinician an idea of patient dysfunction perception. This was a prospective study of 80 patients with epilepsy. 35 patients admitted to Epilepsy monitoring unit (EMU) either for pre-surgical work up or classification of the epilepsy syndrome and 45 patients followed at epilepsy clinic were included in the study. The following information was obtained; Age, gender, age of onset, number of current antiepileptic drugs (AEDs) on and number of past AEDs ,epilepsy syndrome, number of seizures past month, presence of generalized tonic clonic seizures Results: The average age was 34.4 in EMU group, 36.5 in outpatient group. The most common epilepsy syndrome was localization related epilepsy. The groups were similar in age, number of AEDs, past AEDs, percent with localization related epilepsy, days with seizures and self disability report. We found that there was no significant difference between the two groups (15.8 compared to 10.9) p<0.55. Self disability report was slightly higher in the EMU subjects p<0.52. Conclusions: There is a clinical need for a scale to evaluate the intermittent disability that epilepsy patients suffer when they have seizures or medication side effects . We hypothesized that EMU patients would be more disabled than outpatients and tested the SERDAS scale in the two groups. Our results show that the groups were similar in age, number of AEDs, past AEDs, percent with localization related epilepsy, days with seizures, self disability, and SERDAS scores. We found that there was no significant difference between the SERDAS scores for two groups, possibly because the two groups had such similar characteristics. In the future we will pilot the SERDAS again, but we will use groups that are more clearly distinct clinically.