Impact of epilepsy and antiepileptic drugs on health and quality of life in Indian children.

BACKGROUND AND OBJECTIVES: Epilepsy affects the physical, cognitive, emotional, social wellbeing, and thereby the overall quality of life (QOL). Epilepsy is the most prevalent neurological disorder in the pediatric age group with a prevalence of 3.13 to 3.73 per 1000 in India. It is imperative for the primary caregiver to look beyond seizure control for improving wellbeing of children with epilepsy (CWE). Hence, there is a need to understand the predictors of QOL in Indian CWE. The objective of this study was to assess the impact of epilepsy and antiepileptic medications on the child's development, health, scholastic performance, and QOL and to identify the predictors of QOL.

METHODS: This study was a cross-sectional hospital-based prospective study with sociodemographic, clinical data collected from 110 children (age 4-18 years). Seizure severity was assessed with the Hague Seizure Severity Scale, and adverse effects of antiepileptic drugs (AEDs) were assessed using the Adverse Event Profile Scale. The QOL was measured employing the Quality of Life in Children with Epilepsy (QOLCE) questionnaire.

RESULTS: The mean total QOLCE score was 72.6 ± 13.6. Among the subscale scores, memory had the highest mean of 86.5, and the lowest mean was observed for QOL item (40.4). There was no significant association of the total QOLCE score with any of the sociodemographic variables such as gender, place, socioeconomic status, paternal/maternal education, or family type. Children with more severe seizures had significantly lower energy and QOL subscale scores and greater depression and anxiety. Prolonged duration of epilepsy, frequent seizures, and recent seizures had a significant negative correlation with the mean total QOLCE score. Children with epilepsy who are on multiple AEDs, prolonged duration of AED intake, or poor adherence to AEDs have significantly lower total QOLCE score. Children manifesting adverse effects to AEDs had significantly lower overall QOL affecting all domains.

CONCLUSION: Overall QOL in CWE is most compromised by polytherapy, poor adherence to medication, adverse effects of AEDs, hospitalization, and presence of developmental delay.