Quality of life in patients with idiopathic, generalized epilepsy

The quality of life (QOL) in patients with idiopathic, generalized epilepsy (IGE) was assessed in 48 patients using the Quality of Life in Epilepsy in ventory (QOLIE). Eleven recently diagnosed IGE patients (short-terms) were tested at 0 and 4 weeks, and at 6 months following initial diagnosis and tr eatment with sodium valproate. These patients were compared to 18 IGE patie nts who had been taking valproate for more than 1 year (long-terms) and to 19 normal controls. Both groups of IGE patients also were administered the A-B Neurotoxicity Scale and Liverpool Seizure Severity Scale. Recently diag nosed patients scored significantly lower than controls and long-terms on t he following QOLIE subscales: work/driving/social function, health discoura gement, seizure worry, medication effects, change in health, and overall he alth. Only with regard to the role limitation-physical subscale did both IG E groups score significantly more poorly than controls. The overall QOL sco re was significantly different among groups, with the controls scoring high est and the short-terms lowest. Short-terms reported significantly less sei zure-associated distress on the Seizure Severity Scale at 4 weeks as compar ed to the initial test at 0 weeks. This effect was evident for both perceiv ed control of major seizures and severity of postictal events. Seventy perc ent of short-terms were seizure-free by 4 weeks following initial diagnosis and treatment. The QOL was inversely correlated with both seizure severity and neurotoxicity scores. Taken together, these data indicate that QOL is significantly poorer in recently diagnosed patients than in patients with l ong-term epilepsy. Moreover, on most indices of QOL, long-term patients did not differ significantly from normal controls, indicating that the postdia gnosis decline in QOL is transient. These findings suggest that QOL, in pat ients with IGE, changes throughout the course of the illness, and that foll owing treatment with valproate, successful seizure control and restored QOL is possible.