 |
Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312 773X (Online)
Issue: 2013, vol. 19, book 3;
Subject Collection: Medicine
Page: 433-437
DOI: 10.5272/jimab.2013193.433
Published online: 18 July 2013
J of IMAB. 2013 Jul-Dec;19(3):433-437;
SEIZURE SEVERITY AS AN ALTERNATIVE MEASURE OF OUTCOME IN EPILEPSY
Koraliya S. Todorova 1
, Valentina S. Velikova2, Ara G. Kaprelyan3, Stefan T. Tsekov4,
1) First Clinic of Psychiatry, MHAT "St. Marina" - Varna, 2) Faculty of Dental Medicine, 3) Department of Neurology, First Clinic of Neurology, MHAT "St. Marina" - Varna, 4) Medical College, Medical University of Varna, Bulgaria.
ABSTRACT:
Seizure severity emerges as an important aspect of epilepsy. This is most relevant in refractory patients in whom complete remission of seizures is unlikely and reduced seizure severity may be a significant determinant of psychosocial well-being with a consequent improvement in quality of life (QOL). Thus a valid measure of seizure severity can serve both as an indicator of clinical outcome and as an evaluation tool of the interaction between seizures and the psychosocial complications of epilepsy.
After a brief review of the most frequently used scales measuring seizure severity in adults with epilepsy we have explored the relationship between seizure severity and QOL in a set of 103 patients. Two self-evaluation questionnaires were applied: the Seizure Severity Questionnaire (SSQ) and the Quality of Life in Epilepsy Inventory (QOLIE-31). The severity of the coexisting depression, an important confounder in the relationship between seizure severity and QOL, was assessed by the Hamilton Depression Rating Scale (HAMD-17).
All domains of the Quality-of-Life in Epilepsy Inventory (QOLIE-31) correlated highly significantly with seizure severity (p≤0.01). The correlation was strong for the Overall score (r=-0.70; p≤0.001) and the Seizure worry domain (r=-0.71; p≤0.001). When the potentially confounding effect of depression was controlled for, the regression of seizure severity with the QOLIE-31 Overall score (P=0.001; R²=0.56) and the Seizure worry domain (P=0.001; R²=0.50) remained significant. These findings indicate that seizure severity is strongly associated with QOL in epilepsy and could be used as an alternative indicator of outcome in clinical research.
Key words: Seizure severity; Epilepsy; Quality of life; Seizure Severity Questionnaire.
- Download FULL TEXT /PDF 589 KB/
Please cite this article as:
Todorova KS, Velikova VS, Kaprelyan AG, Tsekov ST. Seizure Severity as an Alternative Measure of Outcome in Epilepsy. J of IMAB. 2013 Jul-Dec;19(3):433-437. DOI: 10.5272/jimab.2013193.433.
Correspondence to: Dr Koraliya Todorova, First Clinic of Psychiatry, MHAT "St. Marina"-Varna; 1, H. Smirnenski str., Varna 9010, Bulgaria; koralia.todorova@yahoo.com
1.Carpay HA, Arts WF. Outcome assessment in epilepsy: available rating scales for adults and methodological issues pertaining to the development of scales for childhood epilepsy. Epilepsy Res. 1996 Jul;24(3):127-136. [PubMed] [CrossRef]
2. Smith D, Baker GA, Jacoby A, Chadwick DW. The contribution of the measurement of seizure severity to quality of life research. Qual Life Res. 1995 Apr;4(2):143-158. [PubMed]
3. Cramer JA, Smith DB, Mattson RH, Delgado Escueta AV, Collins JF. A method of quantification for the evaluation of antiepileptic drug therapy. Neurology. 1983 Mar;33(3 Suppl 1):26-37. [PubMed]
4. Cramer JA, French J. Quantitative Assessment of Seizure Severity for Clinical Trials: A Review of Approaches to Seizure Components. Epilepsia. 2001 Jan;42(1):119-129. [PubMed] [CrossRef]
5. Duncan JS, Sander JW. The Chalfont Seizure Severity Scale. J Neurol Neurosurg Psychiatry. 1991 Oct;54(10):873-876. [PubMed]
6. O’Donoghue MF, Duncan JS, Sander JW. The National Hospital Seizure Severity Scale: A Further Development of the Chalfont Seizure Severity Scale. Epilepsia. 1996 Jun;37(6):563-571. [PubMed]
7. Baker GA, Smith DF, Dewey M, Morrow J, Crawford PM, Chadwick DW. The development of a seizure severity scale as an outcome measure in epilepsy. Epilepsy Res. 1991 Apr;8(3):245-251. [PubMed]
8. Baker GA. Health-related quality-of-life issues: optimizing patient outcomes. Neurology. 1995 Mar;45 (3 Suppl.2):29-34. [PubMed]
9. Cramer JA, Baker GA, Jacoby A. Development of a new seizure severity questionnaire: initial reliability and validity testing. Epilepsy Res. 2002 Feb;48(3):187-197. [PubMed]
10. Cramer JA, Blum D, Reed M, Fanning K. Epilepsy Impact Project Group. The influence of comorbid depression on seizure severity. Epilepsia.2003 Dec;44(12):1578–1584. [PubMed] [CrossRef]
11. Swaine-Verdier A, Doward LC, Hagell P, Thorsen H, Mc Kenna SP. Adapting quality of life instruments. Value Health. 2004 Sep-Oct;7 Suppl 1:S27-30. [PubMed]
12. World Health Organization. The ICD-10 Classification of Mental and Behavioral Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organization 1992.
13. Cramer JA, Perrine K, Devinsky O, Bryant-Comstock L, Meador K, Hermann BP. Development and cross-cultural translation of a 31-item quality of life in epilepsy questionnaire (QOLIE-31). Epilepsia. 1998 Jan;39(1):81-88. [PubMed]
14. Devinsky O, Vickrey BG, Cramer JA, Perrine K, Hermann BP, Meador K, et al. Development of the quality of life in epilepsy inventory. Epilepsia. 1995 Nov;36(11):1089-1104. [PubMed]
15. Todorova KS, Velikova VS, Tsekov ST. Psychometric properties of the Bulgarian version of the Quality of Life in Epilepsy Inventory (QOLIE-31). Epilepsy Behav. 2013 Aug;28(2):203-210. [CrossRef]
16. Hamilton M. A rating scale for depression. JNeurol Neurosurg Psychiatry. 1960 Feb;23: 56-62. [PubMed] [CrossRef]
17. Cramer J. A clinimetric approach to assessing quality of life in epilepsy. Epilepsia. 1993; 34(Suppl 4):S8-13. [PubMed]
18. Sancho J, Iváñez V, Molins A, López Gómez V, Masramón X, Pérez M. Changes in seizure severity and quality of life in patients with refractory partial epilepsy. Epilepsy Behav. 2010 Nov;19(3):409-413. [PubMed] [CrossRef]
19. Hermann BP, Seidenberg M, Bell B, Woodard A, Rutecki P, Sheth R. Comorbid psychiatric symptoms in temporal lobe epilepsy: association with chronicity of epilepsy and impact on quality of life. Epilepsy Behav. 2000 Jun;1(3):184-190. [PubMed] [CrossRef]
20. Harden C, Maroof D, Nikolov B, Fowler K, Sperling M, Liporace J, et al. The effect of seizure severity on quality of life in epilepsy. Epilepsy Behav. 2007 Sep;11(2):208-211. [PubMed] [CrossRef]
21. Cramer JA, Brandenburg N, Xu X. Differentiating anxiety and depression symptoms in patients with partial epilepsy. Epilepsy Behav. 2005 Jun;6(4):563-569. [Pubmed] [CrossRef] .
Accepted for publication: 16 April 2013
Published online: 18 July 2013