Quality of life in childhood epilepsy with lateralized epileptogenic foci

Krystyna A Mathiak,Małgorzata Luba,Paweł Ostaszewski,Klaus Mathiak,Katarzyna Karzel,Elżbieta Szczepanik,Tomasz Wolańczyk,Elzbieta Szczepanik

doi:10.1186/1471-2377-10-69

Abstract

BackgroundMeasuring quality of life (QOL) helps to delineate mechanisms underlying the interaction of disease and psychosocial factors. In adults, epileptic foci in the left temporal lobe led to lower QOL and higher depression and anxiety as compared to the right-sided foci. No study addressed the development of QOL disturbances depending on the lateralization of epileptogenic focus. The objective of our study was to examine QOL in children with lateralized epileptiform discharges.MethodsThirty-one parents of children with epilepsy filled the Health-Related Quality of Life in Childhood Epilepsy Questionnaire (QOLCE). Fifteen children had foci in the left hemisphere and sixteen in the right, as verified with Electroencephalography (EEG) examinations.ResultsWe found a significant correlation between foci lateralization and reduced QOL (Spearman's rho = 0.361, p < 0.046). Children with right hemispheric foci exhibited lower overall QOL, particularly in five areas: anxiety, social-activities, stigma, general-health, and quality-of-life.ConclusionsWe demonstrated for the first time that in children left- and right-hemispheric foci were associated with discordant QOL scores. Unlike in adults, foci in the right hemisphere led to worse emotional and social functioning demonstrating that seizures impact the brain differentially during development.

Highlights

Measuring quality of life (QOL) helps to delineate mechanisms underlying the interaction of disease and psychosocial factors
Patients were included in the presence of (1) unilateral epileptic focus as determined by presence of epileptiform activity in EEG examinations, (2) age in the range of 6-15 years, (3) normal intelligence (IQ above 85 in Wechsler’s scale), and (4) no accompanying chronic diseases that was not a direct outcome of epilepsy, such as asthma or diabetes, or any disease that started before the onset of epileptic seizures
We have demonstrated for the first time that in children lateralized epileptiform discharges have a differential impact on QOL

Summary

Introduction

Measuring quality of life (QOL) helps to delineate mechanisms underlying the interaction of disease and psychosocial factors. No study addressed the development of QOL disturbances depending on the lateralization of epileptogenic focus. The objective of our study was to examine QOL in children with lateralized epileptiform discharges. Quality of life (QOL) is an important outcome measure in clinical research, taking into account patient’s subjective evaluation of his own being and supplementing the traditional medical approach, based on the examination of symptoms, signs, and laboratory findings as defined from the doctor’s perspective [1]. The improvement of clinical parameters only, even including remission, does not need to lead to the improvement of social functioning and subjective QOL [6,7]

Objectives

Methods

Results

Discussion

Conclusion