Neuropediatrics 2006; 37 - THP119
DOI: 10.1055/s-2006-945942

CHILDREN AND ADOLESCENTS WHO WERE REJECTED FOR EPILEPSY SURGERY: NO DOWNWARD COURSE OF EPILEPSY AND MOTOR FUNCTIONING, BUT QUALITY OF LIFE AND SELF-PERCEIVED COMPETENCE MAY WORSEN

R van Empelen 1, A Jennekens-Schinkel 1, P Helders 1, P van Rijen 1, O van Nieuwenhuizen 1
  • 1University Children's Hospital and Medical Center, Utrecht, The Netherlands

Objectives: To study whether severity of epilepsy, motor functioning, health-related quality of life (HrQoL) and epilepsy-related restrictions change in children with medically intractable epilepsy who are not eligible for epilepsy surgery.

Methods: Prospective longitudinal 2-year follow-up of 45 children with medically intractable epilepsy (aged 6 months to 15 years). Data were analysed non-parametrically and by means of ANOVA for repeated measures and correlation and regression analysis.

Results: Seizure severity nor muscle strength, range of motion and tone changed significantly. Motor retardation was ubiquitous but did not increase in 33 children without spasticity. Motor function of 12 children with spasticity developed, but remained poor in four (>2 SD worse than reference values). In the complete group, functional skills increased and caregiver assistance lessened. HrQoL: Group-wise, parents and children evaluated the frequency of social activities as significantly less than normal (p<0.05) in the time of the consultations and during follow-up. Restrictions did not change significantly.

Conclusion: Of children with medically intractable epilepsy who have to do without surgical intervention and in whom no other adverse events occur, seizure severity does not progress, motor impairments do not increase, motor development does not deflect negatively and activities of daily living and restrictions do not worsen. But Health related quality of life worsens selectively in the two years of follow up.