QUALITY OF LIFE IN IRANIAN EPILEPTIC CHILDREN

Objectives: To study the impact of epilepsy and its treatment on the quality of life in Iranian children with unprovoked epilepsy visiting Children's Hospital Medical Center, Tehran.

Methods: 60 children with known epilepsy were selected from the out patient department of Children Medical Center of Tehran University of Medical Sciences, Tehran, between Farwardin 1383 and Mehr 1383 (March 2004 and September 2004 AD). All subjects and their parents were asked about the quality of life assessment in a questionnaire prepared according to Child self-report scale & Parent proxy response scales which were modified according to the local culture and awareness of disease, in an interview setting.

Results: The sample of 60 children was predominantly male with 36 boys (60%) and 24 girls (40%) with a mean age of 10.33 years (S.D.=1.38). Out of these, 40 were from big cities (66.7%), 15 from small cities (25%) and 5 from villages (8.3%). The types of seizure distribution were Generalized Tonic Clonic Seizure (56.7%), Absence (23.3%) and others. 48 patients (80%) were being treated with one antiepileptic drug (AED), and 10 (16.7%) were being treated with two or more AEDs. Analysis of the QOLQ-20 revealed the overall QOL score expressed by patients themselves as: mean score as 27 (SD=4.66) out of total score of 40, the minimum and the maximum score as 15 and 35 respectively. The groups of QOL as graded in analysis plan were scored by both patients and parents. 18 subjects (30%), who were patients themselves, were categorized in group A (Satisfactory) of QOL scoring (≥30 point), 28 (46.7%) were in group B (Relatively Satisfactory) (25–29), 10 (16.7%) were in group C (Dissatisfactory) (20–24) and only 4(6.7%) were listed in group D (Poor) ((<20 score). On the other hand, 28 subjects (46.7%) were categorized by parents in group A of QOL scoring (≥30 point), 17 (28.3%) were in group B (25–29), 7 (11.7%) were in group C (20–24) and only 8 (13.3%) were listed in group D (<20 scores).

Conclusion: In accordance with the previous studies from the developed countries, we also found reduced QOL in children with epilepsy. However, our results show an upper trend, reflecting a better QOL in patients. We have shown that four sub-scales which include life status, worries, school performance and relationship with others, are obviously affected and around one-third of the subjects had satisfactory QOL based on child measure scale and less than half of the subjects had satisfactory QOL based on parent measure scale. In addition, the concerns that were not significantly affected in this study included going away to picnic or similar places, comfort at school, good teacher behaviors, number of friends and well being that is explainable by previous studies. These results can guide the caring physicians with regards to the relevant concerns of patients and parents in providing better treatment and further improvement of QOL in pediatric epilepsy patients.