QUALITY-OF-LIFE PERCEPTION IN PATIENTS WITH INTRACTABLE EPILEPSY OR PSEUDOSEIZURES

Objectives: To contrast and compare self-reported quality of life in p atients with intractable epilepsy and pseudoseizures and to examine th e relationship between self-reports and objective measures of cognitiv e functioning in both of these groups. Design: Case series using profi le analysis and analysis of covariance. Setting: University epilepsy s urgery program. Participants: Forty-three patients with intractable co mplex partial seizures of unilateral temporal lobe origin and 25 patie nts with pseudoseizures. Measures: Quality of Life in Epilepsy Invento ry-89; neuropsychological tests assessing verbal memory, nonverbal mem ory, naming, and attention; and the Depression Scale (2) of the MMPI-2 . (Minnesota Multiphasic Personality Inventory). Results: Patients wit h pseudoseizures described themselves as more Limited in the physical health domain than patients with complex partial seizures. Self-percep tions of cognitive functioning were similar between groups, despite th e superior performance of patients with pseudoseizures on objective me asures. Self-perception of cognitive dysfunction was related to mood d isorder in the pseudoseizure group only, and there were no relationshi ps between subjective and objective measurements of cognitive status w ithin this group independent of mood disorder. For the complex partial seizures group, relationships between subjective and objective measur es of cognitive function were dependent on the side of seizure onset. Conclusions: Results are consistent with hypotheses that suggest that patients with pseudoseizures focus on physical rather than psychologic al explanations for stress, and that this focus is related, at least i n a subgroup of patients, to mood disorder. Results also provide suppo rt for the validity of the Quality of Life in Epilepsy Inventory-89 in populations with intractable seizure disorder, although there is evid ence for a possible floor effect on some of the subscales.