Artikel
Health related quality of life in patients with medically treated cerebral cavernous malformation related epilepsy
Gesundheitsbezogene Lebensqualität bei Patienten mit medizinisch behandelter zerebraler kavernöser Fehlbildung bei Epilepsie
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Veröffentlicht: | 4. Juni 2021 |
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Objective: To estimate the health-related quality of life (HRQOL) in patients with untreated cerebral cavernous malformation related epilepsy (CRE).
Methods: We performed a prospective cross-sectional study on patients with CRE admitted to our hospital between 2018 and 2020 using standardized interviews such as the hospital anxiety/depression scale (HADS-D-A/D), quality of life questionnaire (SF-36) and visual analogue scale (VAS) assessing subjective CRE disease burden. CRE patients surgically treated prior to our assessment, with incomplete clinical data and with insufficient knowledge of German language were excluded from the study. Health-related quality of life (HRQOL) data were analyzed and compared to an age- and sex-matched German normal population. Uni- and multivariate analyses were carried out to identify variables that show an impact on HRQOL outcome.
Results: We included 37 CRE patients with a mean age of 46.7 ± 13.6 years (SD). 18 (48.6%) patients presented with symptomatic hemorrhage (SH) and 20 (54.1%) had multiple CCM. 15 patients (40,5%) suffered from comorbidities. 25 patients (67.6%) had only 1 seizure. 29 patients (78.4%) received anticonvulsive therapy at time of HRQOL assessment. The mean time between last CCM-related seizure and HRQOL survey was 41.7 ± 84.6 months (SD). CRE patients showed significantly lower scores in some of the SF-36 subdomains such as physical (RP) (p = 0,007), social (SF) (p = 0,001) and emotional functioning (RE) (p < 0,001), as well as in the mental health component score (MCS) (p = 0.001). Univariate and multivariate analysis identified multiple seizures, timeframe of more than 3 months between first and last seizure and comorbidities as predictors of HRQOL impairment. A significant correlation between VAS and MCS confirmed that the decreased HRQOL values are largely based on CRE manifestation.
Conclusion: We present an observational study on HRQOL in patients with untreated CRE. Patients with CRE revealed in some domains a decreased HRQOL compared to the normal population, even when not suffering from functional impairment. Our data reflects the disease burden of patients with CRE.