The aim of this work was to assess the health-related quality of life (HRQL
) of patients pre and post surgical treatment for epilepsy. A total of 145
patients were interviewed during their pre-surgical assessment on the telem
etry unit, Queen Square. The HRQL assessment comprised the quality of life
assessment schedule (QOLAS), the EuroQol EQ-5D and the epilepsy surgery inv
entory (ESI-55). A total of 40 patients were followed up, of which 22 had u
ndergone surgery and achieved 75% or greater reduction in seizures. The QOL
AS scores for the patients who achieved 75% or greater seizure reduction po
st-op were significantly lower (i.e. improved HRQL) compared to baseline. T
he descriptive data suggest that the EQ-5D may not be capturing all of the
QOL issues of relevance to patients with chronic, intractable epilepsy and
the EQ-5D may not be valid for this group. Most patients queried the visual
analogue scale (VAS) which asks for an overall rating of the respondent's
self-perceived health. The most frequent comments, from 42% of patients, wa
s that 'health' did not include their epilepsy. Despite this, the group who
se seizures were reduced had significantly higher VAS scores at follow-up.
We can conclude that the VAS is sensitive to clinical change. The baseline
EQ-5D utility and follow-up scores were compared. There were no significant
changes in QOL scores for either group. The patients who achieved 75% or g
reater reduction in seizures post-op scored significantly higher (i.e. bett
er QOL) on 2/3 composite scores of the ESI-55 at follow-up. The QOLAS, the
EQ-5D VAS and the ESI-55 were sensitive to clinically defined outcome. The
results for the EQ-5D profile and the EQ-5D utility suggest that the EQ-5D
is not a valid and responsive instrument for use in patients with intractab
le epilepsy. (C) 2000 Published by Elsevier Science B.V. All rights reserve
d.