Relationships between seizure severity and health-related quality of life in refractory localization-related epilepsy

Purpose: To evaluate relationships between self-report measures of seizure severity and health-related quality of life (HRQOL) in people with refracto ry localization-related epilepsy. Methods: A sample of 340 adults enrolled in a seven-center, prospective stu dy of resective epilepsy surgery completed baseline questionnaires that inc luded the Quality of Life in Epilepsy (QOLIE)-89 and a seven-item adaptatio n of the National Hospital Seizure Severity Scale. Associations between QOL IE-89 summary measures and both the total seizure severity scale score and individual seizure severity items were assessed, after adjustment for seizu re frequency. Results: The seizure severity measure had adequate scale score variability and reliability in this sample. Correlations between individual items in th e scale did not exceed 0.43. Product-moment partial correlations between th e seizure severity scale and QOLIE-89 summary measures ranged from -0.17 to -0.29 tall p values <0.01). OF the seven seizure severity items, the avera ge time before individuals perceived they were "really back to normal" afte r their seizures was broadly related to all domains of HRQOL (r values rang ed from -0.16 to -0.30; p values <0.01). Severity of injury during seizures was the only other item having more than minimal associations with HRQOL, and it was selectively related to the physical health measure. Higher frequ ency of falls during seizures was modestly related to less employment. Conclusions: This seizure severity measure assesses constructs that are gen erally distinct from HRQOL, except for moderate and broad associations betw een HRQOL and patient's perceptions of the average duration of recovery tim e after seizures. Recovery time may potentially be a useful clinical indica tor of seizure severity that reflects meaningful impairment of HRQOL in adu lts with frequent seizures.