Skip to main content

Advertisement

SpringerLink
Log in

The impact of epilepsy on subjective health status

  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

Abstract

Epilepsy is a chronic disorder that has complex effects on many aspects of personal health. Recent advances in the methods to reliably and validly assess subjective health status have allowed major advances in our understanding of these diverse effects, and have also provided evidence to guide treatment and future research. Studies that have included measures of quality of life, patient preferences, and disability in epilepsy have shown that the magnitude of the adverse effects of recurrent seizures on many aspects of subjective health status is as large as that seen with diabetes mellitus and active cardiovascular disease. Studies of patient-oriented, comprehensive outcomes after epilepsy surgery indicate positive treatment effects in broad areas of function and well-being. Although few trials of epilepsy drugs have included health outcome instruments, available studies suggest that greater than 50% seizure reduction is associated with improved quality of life. Adverse medication effects and depression appear to have a strong association with subjective health status in epilepsy, independent of seizure frequency.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Hermann BP: The evolution of health-related quality of life assessment in epilepsy. Qual Life Res 1995, 4:87–100.

    Article  PubMed  CAS  Google Scholar 

  2. Vickrey BG, Hays RD, Rausch R, et al.: Quality of life of epilepsy surgery patients as compared with outpatients with hypertension, diabetes, heart disease, and/or depressive symptoms. Epilepsia 1994, 35:597–607.

    Article  PubMed  CAS  Google Scholar 

  3. Clancy CM, Eisenberg JM: Outcomes research: measuring the end results of health care. Science 1998, 282:245–246.

    Article  PubMed  CAS  Google Scholar 

  4. Devinsky O: Outcome research in neurology: incorporating health-related quality of life [editorial; comment]. Ann Neurol 1995, 37:141–142.

    Article  PubMed  CAS  Google Scholar 

  5. Gilliam F: Health outcomes in persons with epilepsy. Neurol Clin 2001, 19:465–475.

    Article  PubMed  CAS  Google Scholar 

  6. Penfield W, Paine K: Results of surgical therapy for epileptic seizures. Can Med J 1955, 73:515–530.

    CAS  Google Scholar 

  7. Levin R, Banks S, Berg B: Psychosocial dimensions of epilepsy: a review of the literature. Epilepsia 1988, 29:805–816.

    PubMed  CAS  Google Scholar 

  8. Collings JA: Psychosocial well-being and epilepsy: an empirical study. Epilepsia 1990, 31:418–426.

    PubMed  CAS  Google Scholar 

  9. Collings JA: Epilepsy and well-being. Soc Sci Med 1990, 31:165–170.

    Article  PubMed  CAS  Google Scholar 

  10. Harrison RM, Taylor DC: Childhood seizures: a 25-year follow up. Social and medical prognosis. Lancet 1976, 1:948–951.

    Article  PubMed  CAS  Google Scholar 

  11. Guldvog B, Loyning Y, Hauglie-Hanssen E, et al.: Surgical versus medical treatment for epilepsy. II. Outcome related to social areas. Epilepsia 1991, 32:477–486.

    PubMed  CAS  Google Scholar 

  12. Ware JE Jr: Standards for validating health measures: definition and content. J Chronic Dis 1987, 40:473–480.

    Article  PubMed  Google Scholar 

  13. Stewart AL, Greenfield S, Harys RD, et al.: Functional status and well-being of patients with chronic conditions: results from the Medical Outcomes Study. JAMA 1989, 262:907–913.

    Article  PubMed  CAS  Google Scholar 

  14. Vickrey BG, Hays RD, Graber J, et al.: A health-related quality of life instrument for patients evaluated for epilepsy surgery. Med Care 1992, 30:299–319.

    Article  PubMed  CAS  Google Scholar 

  15. Devinsky O, Vickrey BG, Cramer J, et al.: Development of the quality of life in epilepsy inventory. Epilepsia 1995, 36:1089–1104.

    Article  PubMed  CAS  Google Scholar 

  16. Baker GA: Quality of life and epilepsy: the Liverpool experience. Clin Ther 1998, 20(suppl A):A2–12.

    Article  PubMed  Google Scholar 

  17. O’Donoghue MF, Duncan JS, Sander JW: The subjective handicap of epilepsy. A new approach to measuring treatment outcome. Brain 1998, 121(Pt 2):317–343.

    Article  PubMed  Google Scholar 

  18. Patrick DL, Deyo RA: Generic and disease-specific measures in assessing health status and quality of life. Med Care 1989, 27(suppl 3):S217–232.

    Article  PubMed  CAS  Google Scholar 

  19. Baker GA, Jacoby A, Buck D, et al.: Quality of life of people with epilepsy: a European study. Epilepsia 1997, 38:353–362.

    Article  PubMed  CAS  Google Scholar 

  20. Kwan P, Brodie MJ: Early identification of refractory epilepsy. N Engl J Med 2000, 342:314–319.

    Article  PubMed  CAS  Google Scholar 

  21. Sillanpaa M, Jalava M, Kaleva O, et al.: Long-term prognosis of seizures with onset in childhood [see comments]. N Engl J Med 1998, 338:1715–1722.

    Article  PubMed  CAS  Google Scholar 

  22. Mattson RH, Cramer JA, and Collins JF: Prognosis for total control of complex partial and secondarily generalized tonic clonic seizures. Department of Veterans Affairs Epilepsy Cooperative Studies No. 118 and No. 264 Group. Neurology 1996, 47:68–76.

    PubMed  CAS  Google Scholar 

  23. Leidy NK, Elixhauser A, Vickrey B, et al.: Seizure frequency and the health-related quality of life of adults with epilepsy. Neurology 1999, 53:162–166.

    PubMed  CAS  Google Scholar 

  24. Vickrey BG, Hays RD, Engel J Jr, et al.: Outcome assessment for epilepsy surgery: the impact of measuring health-related quality of life [see comments]. Ann Neurol 1995, 37:158–166.

    Article  PubMed  CAS  Google Scholar 

  25. Blum DE, Eskola J, Bortz JJ, et al.: Patient awareness of seizures. Neurology 1996, 47:260–264.

    PubMed  CAS  Google Scholar 

  26. Vickrey BG, Berg AT, Sperling MR, et al.: Relationships between seizure severity and health-related quality of life in refractory localization-related epilepsy. Epilepsia 2000, 41:760–764.

    Article  PubMed  CAS  Google Scholar 

  27. Jacoby A, Baker GA, Steen N, et al.: The clinical course of epilepsy and its psychosocial correlates: findings from a U.K. Community study. Epilepsia 1996, 37:148–161.

    Article  PubMed  CAS  Google Scholar 

  28. Edeh J, Toone B: Relationship between interictal psychopathology and the type of epilepsy. Results of a survey in general practice. Br J Psychiatry 1987, 151:95–101.

    Article  PubMed  CAS  Google Scholar 

  29. Mendez MF, Cummings JL, Benson DF: Depression in epilepsy. Significance and phenomenology. Arch Neurol 1986, 43:766–770.

    PubMed  CAS  Google Scholar 

  30. Perrine K, Hermann BP, Meador KJ, et al.: The relationship of neuropsychological functioning to quality of life in epilepsy [see comments]. Arch Neurol 1995, 52:997–1003.

    PubMed  CAS  Google Scholar 

  31. Hermann BP, Seidenberg M, Bell B, et al.: Comorbid psychiatric symptoms in temporal lobe epilepsy: association with chronicity of epilepsy and impact on quality of life. Epilepsy Behav 2000, 1:184–190.

    Article  PubMed  Google Scholar 

  32. Gilliam F, Kuzniecky R, Meador K, et al.: Patient-oriented outcome assessment after temporal lobectomy for refractory epilepsy [see comments]. Neurology 1999, 53:687–694.

    PubMed  CAS  Google Scholar 

  33. Vickrey BG, Hays RD, Rausch R, et al.: Outcomes in 248 patients who had diagnostic evaluations for epilepsy surgery. Lancet 1995, 346:1445–1449.

    Article  PubMed  CAS  Google Scholar 

  34. McLachlan RS, Rose KJ, Derry PA, et al.: Health-related quality of life and seizure control in temporal lobe epilepsy. Ann Neurol 1997, 41:482–489.

    Article  PubMed  CAS  Google Scholar 

  35. Markand ON, Salanova V, Whelihan E, et al.: Health-related quality of life outcome in medically refractory epilepsy treated with anterior temporal lobectomy. Epilepsia 2000, 41:749–759.

    Article  PubMed  CAS  Google Scholar 

  36. Wiebe S, Blume WT, Girvin JP, et al.: A randomized, controlled trial of surgery for temporal-lobe epilepsy. N Engl J Med 2001, 345:311–318.The first randomized, controlled trial of outcome after epilepsy surgery, demonstrating improved quality of life after temporal lobe resection compared with continued medical treatment.

    Article  PubMed  CAS  Google Scholar 

  37. Cramer JA, Arrigo C, Van Hammee G, et al.: Effect of levetiracetam on epilepsy-related quality of life. N132 Study Group. Epilepsia 2000, 41:868–874.

    Article  PubMed  CAS  Google Scholar 

  38. Cramer JA: Exploration of changes in health-related quality of life after 3 months of vagus nerve stimulation. Epilepsy Behav 2001, 2:460–465.

    Article  PubMed  Google Scholar 

  39. Dodrill CB, Morris GL: Effects of vagal nerve stimulation on cognition and quality of life in epilepsy. Epilepsy Behav 2001, 2:46–53.

    Article  PubMed  Google Scholar 

  40. Gilliam F, Kuzniecky R, Faught E, et al.: Patient-validated content of epilepsy-specific quality-of-life measurement. Epilepsia 1997, 38:233–236.

    Article  PubMed  CAS  Google Scholar 

  41. Gilliam F: Optimizing health outcomes in active epilepsy. Neurology 2002, 58(8 suppl 5):S9-S20.

    PubMed  Google Scholar 

  42. Baker GA, Frances P, Middleton E: Initial development, reliability, and validity of a patient-based adverse events scale. Epilepsia 1994, 35(suppl 7):80.

    Google Scholar 

  43. Lustman PJ, Clouse RE, Griffith LS, et al.: Screening for depression in diabetes using the Beck Depression Inventory [see comments]. Psychosom Med 1997, 59:24–31.

    PubMed  CAS  Google Scholar 

  44. Kanner AM, Nieto JC: Depressive disorders in epilepsy. Neurology 1999, 53(5 suppl 2):S26–32.

    PubMed  CAS  Google Scholar 

  45. Kanner AM, Palac S: Depression in epilepsy: a common but often unrecognized comorbid malady. Epilepsy Behav 2000, 1:37–51.

    Article  PubMed  Google Scholar 

  46. Barry JJ, Huynh N, Lembke A: Depression in individuals with epilepsy. Curr Treat Options Neurol 2000, 2:571–585.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Washington University Epilepsy Program, 660 South Euclid Avenue, Campus Box 8111, 63110, St. Louis, MO, USA

    Frank Gilliam MD, MPH

Authors
  1. Frank Gilliam MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gilliam, F. The impact of epilepsy on subjective health status. Curr Neurol Neurosci Rep 3, 357–362 (2003). https://doi.org/10.1007/s11910-003-0014-0

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11910-003-0014-0

Keywords

Search

Navigation