NEW ORLEANS—Children with epilepsy who have been seizure-free for more than five years have a lower quality of life than children without epilepsy, according to a study presented at the 64th Annual Meeting of the American Academy of Neurology.
Psychiatric disorders, such as depression, and neurodevelopmental disorders, such as language delay, were significantly associated with a worse quality of life, researchers found after adjusting for age, gender, and other covariates. Remote seizure history, attention deficit disorder, and IQ, however, were not associated with a worse quality of life.
Comparing Children With Epilepsy and Their Siblings
Barbara Vickrey, MD, Vice Chair of Academic Affairs for Neurology at the David Geffen School of Medicine, University of California, Los Angeles, and her colleagues sought to determine whether comorbidities unrelated to seizures affect long-term quality of life in children with epilepsy. The investigators examined data from the Connecticut Study of Epilepsy, a prospective, community-based cohort study of children newly diagnosed with epilepsy between 1993 and 1997. Children were enrolled between the ages of 28 days and 15 years. Nine years after enrollment, the children and their parents used the Child Health Questionnaire to assess the quality of life of children with epilepsy and sibling controls.
Dr. Vickrey and her colleagues focused on 177 children from the initial cohort who were seizure-free for more than five years at follow-up. In this group, the mean age of epilepsy onset was 4, and the mean age at follow-up was 13. Slightly more than half of the children were female. Most of the parents were well-educated Caucasian women, 78% of whom were employed.
Psychiatric and Neurodevelopmental Comorbid Disorders
Approximately 7% of the 177 children were currently taking an AED, despite having been seizure-free for more than five years. Nearly all (90%) participants had an IQ higher than 80. Approximately 25% of the sample had a psychiatric disorder, and 23% had a neurodevelopmental disorder. Fourteen percent of the sample had psychiatric and neurodevelopmental disorders, and two-thirds had neither.
“We were not able to examine the impact of neurodevelopmental and psychiatric disorders in the control group, because we did not have the detailed information on them as we did on cases,” Anne Berg, PhD, Research Professor in Pediatrics at Northwestern University Feinberg School of Medicine in Chicago and a coauthor of the study, told Neurology Reviews. “Our inference, however, is that these disorders play a key role in explaining quality-of-life differences between cases and controls.”