Welche Auswirkung hat die neue Definition der „International League Against Epilepsy“ für Epilepsie (ILAE 2014) auf die Lebensqualität der Patienten mit erstem epileptischen Anfall und auf welche Faktoren ist diese Veränderung der Lebensqualität zurückzuführen?
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Philipps-Universität Marburg
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Abstract
An estimated 70 million people worldwide suffer from epilepsy, making epilepsy one of
the most common neurological disorders. The chronicity of the disease is associated
with challenges in social and psychological areas as well as impairments in everyday life.
Various limitations and changes result in a reduced quality of life. Patients with epilepsy
often suffer from psychiatric comorbidities, especially depression, which is one of the
strongest negative predictors of quality of life in epilepsy patients.
In our prospective study, clinical as well as epilepsy-related data of all patients who
suffered a first epileptic seizure between March 24, 2018 and November 30, 2019 and
were treated in the Department of Neurology and Neurosurgery of the UKGM-Marburg
were collected. To assess quality of life and depressive symptoms, the SF-36, BDI-II, and
QOLIE-31 were used immediately after first seizure and at the two follow-up time points
after six and twelve months. A total of 152 patients with first-time epileptic seizure were
included, of which 67.8 % (N = 103) patients received a diagnosis of epilepsy and 32.2 %
(N = 49) did not. The dataset studied consisted of patients who were included within the
first 20 months of the survey and had a complete questionnaire (SF-36, BDI-II, QOLIE-
31) at at least two survey time points (BL, 1st FU, and 2nd FU).
In the present study, the quality of life of patients after first-time epileptic seizure was
assessed immediately after the seizure, after six months, and after twelve months. Using
the data, the development of quality of life in patients with and without epilepsy within
the first year was investigated, and the quality of life of patients with and without
epilepsy was compared over time. Furthermore, the influence of three factors
(depressive symptoms (BDI-II), age, and side effects of antiepileptic medication) on
quality of life was investigated.
Within the first year, neither the mental nor the physical component of quality of life
showed significant change in patients with and without epilepsy. This is most likely due
to the short follow-up in our study. The physical component of quality of life assumed
comparable values in patients with and without epilepsy. In contrast, decreased mental
quality of life was seen in patients with epilepsy compared with patients without
epilepsy at six and twelve months. This fact suggests that quality of life is primarily
determined by emotional well-being and that this well-being is disturbed in the context
of epilepsy. This may be caused by depressive symptoms, which were shown to be the
strongest negative predictor of mental quality of life in epilepsy patients at six and
twelve months. Age emerged as the strongest predictor of the physical component of
quality of life in epilepsy patients at both six and twelve months. This fact is most likely
due to general deterioration of physical capacity and health with increasing age. This
assumption is confirmed by the result that no significant difference was found in the
physical component of quality of life in patients with and without epilepsy. Side effects
of antiepileptic drugs did not show statistically significant influence on quality of life in
patients with epilepsy at any time point.
The reduced quality of life of patients compared with the general population after first-
time epileptic seizure highlights the need for comprehensive monitoring of clinical,
affective, and demographic characteristics immediately after first-time seizure.
According to the results, early diagnosis and treatment of depressive symptoms is
particularly indicated to improve the quality of life of epilepsy patients in the long term.
Regarding future research, on the one hand, the question of further predictors of quality
of life and significance of controversially discussed predictors is certainly interesting. On
the other hand, the development of the quality of life of patients after first seizure with
and without epilepsy should be observed over time using larger data sets and in
comparison, to healthy controls.
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Dates
Created: 2024Issued: 2024-09-16Updated: 2024-09-16
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
Predictors of quality of life in epilepsy patients: Depressive symptoms, age, side effects of seizure-suppressive medicationQuality of life in patients after their first epileptic seizureLebensqualität bei Patienten nach erstem epileptischen AnfallPrädiktoren der Lebensqualität bei Epilepsiepatienten: Depressive Symptome, Alter, Nebenwirkungen der anfallssuppressiven Medikation
DFG-subjects
erster epileptischer AnfallLebensqualität bei EpilepsiepatientenEpilepsiepatienten
DDC-Numbers
610
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Nephuth, Selina: Welche Auswirkung hat die neue Definition der „International League Against Epilepsy“ für Epilepsie (ILAE 2014) auf die Lebensqualität der Patienten mit erstem epileptischen Anfall und auf welche Faktoren ist diese Veränderung der Lebensqualität zurückzuführen?. : Philipps-Universität Marburg 2024-09-16. DOI: https://doi.org/10.17192/z2024.0318.