Abstracts

Rationale: (1) To determine the correlation between family and physician-perceived antiepileptic drug side effects rated on a formal side effects scale. (2) To determine the relationship between parent and physician side effect scores and seizure severity, quality of life, age, cognitive status and number of antiepileptic drugs.Methods: Families of children with epilepsy on >1 antiepileptic drug were prospectively recruited at the time of their neurology clinic visit. Parents and attending neurologists each completed a formal side effects scale (Carpay et al. 1996) and 7 point Likert QOL scale for the child with epilepsy. Parents also completed a formal seizure severity scale (Carpay et al. 1996). Data on age, cognitive status and number of antiepileptic drugs were also collected.Results: Completed forms were obtained from 28 cases. Physician scores on formal side effect rating scales did not correlate with parent scores (r=0.23, p=0.24) and were significantly lower than parent scores (p<0.001). Significant correlations were found between higher parent side effect scores and both greater seizure severity (r=0.42, p<0.03) and poorer parent-rated quality of life (r=0.39, p<0.05). A trend was also noted for a higher parent side effects score and cognitive delay (p<0.07). No significant correlations were found between higher physician side effect scores and any of seizure severity, quality of life, age, cognitive status and number of antiepileptic medications. Conclusions: There is poor correlation between neurologist-perceived and parent-perceived side effects. Formal use of parent-rated side effect scales may lead to more accurate and timely detection of side effects and improve quality of life. However, parent antiepileptic drug side effect ratings, particularly in children with greater neurological disability (cognitive delay and/or severe seizures) may be overstated.