Health-related quality of life in patients with poststroke epilepsy
| Autor: | Nikolaus Galland, Sergiu Groppa, Isabel Kotulla, Anna Krüger, Yaroslav Winter, Naeimeh Daneshkhah |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Visual analogue scale Population 03 medical and health sciences Behavioral Neuroscience Epilepsy 0302 clinical medicine Quality of life Modified Rankin Scale Seizures Internal medicine Germany Surveys and Questionnaires medicine Humans 030212 general & internal medicine education Stroke Depression (differential diagnoses) Fatigue Aged Pain Measurement education.field_of_study business.industry Depression Stroke Rehabilitation Middle Aged medicine.disease humanities Neurology Quality of Life Geriatric Depression Scale Anticonvulsants Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Epilepsybehavior : EB. 80 |
| ISSN: | 1525-5069 |
| Popis: | Background Lesional epilepsy is an important long-term sequela of stroke. Data on health-related quality of life (HrQoL) in patients with poststroke epilepsy are limited. We investigated HrQoL in patients with epilepsy after ischemic stroke and identified independent HrQoL-determinants. Methods and patients All patients with acute ischemic stroke, who were permanent residents in the district Marburg-Biedenkopf (Hessia, Germany, reference population 240,000 inhabitants) were recruited within 12 months in the population-based Marburg Stroke Register (MARSTREG). Follow-up visits were performed after 6, 12, and 24 months, and patients who developed poststroke epilepsy were identified. Data on demographics, antiepileptic drugs (AEDs), stroke severity (National Institute of Heath Stroke Scale (NIHSS), Barthel-Index, modified Rankin Scale), depression (Geriatric Depression Scale), and HrQoL (EQ-5D and EQ VAS) were collected. A multiple regression analysis was performed to identify HrQoL-determinants. Results Among the study participants (n = 374), 23 (6.1%) developed poststroke epilepsy. The HrQoL of patients with poststroke epilepsy was reduced in comparison with patients without seizures (24-month follow-up: EuroQol Visual Analogue Scale (EuroQol-VAS): 55.3 ± 10.7 versus 64.2 ± 11.4, p = 0.03). Seizure frequency, depression, and functional impairment (Barthel-Index) were identified as independent determinants of HrQoL. The adjustment of AEDs between 6-month and 24-month follow-ups resulted in decrease of seizure frequency by 40% and reduction of complications (dizziness by 27.8%, nausea by 52.2%, fatigue by 84.2%). Conclusion Lesional epilepsy is associated with decreased HrQoL in patients with stroke. We identified HrQoL-determinants, which would improve the management of patients with poststroke epilepsy. These determinants include proper adjustment of AEDs with reduction of seizure frequency, treatment of depression, and focused rehabilitation programs for poststroke epilepsy. |
| Databáze: | OpenAIRE |
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