Epilepsy is a life-altering disorder defined by a predisposition to unprovoked seizures, but the important physiological and neuropsychiatric manifestations of epilepsy are outside the scope of this definition
.
Epilepsy has different etiologies, comorbidities, and structural foci
.
Recent studies have shown that these distinctions are critical for understanding their health implications, as epilepsy has a greater physical and neuropsychiatric impact than epilepsy has on prognosis
.
For example, recent studies have found that epilepsy caused by traumatic brain injury (TBI), known as posttraumatic epilepsy (PTE), is associated with a previously unreported quality of life (QOL)
.
Just as PTE may cause additional QOL effects, other considerations, such as response to antiepileptic drugs (ASM), can alter physical and mental health in specific ways
.
For example, patients with drug-resistant epilepsy have higher rates of physical injury and mortality, cognitive impairment, and psychiatric symptoms compared with patients with non-resistant epilepsy
.
However, little is known about how DRE, PTE, and other physiological/neuropsychiatric disorders interact and regulate quality of life
.
.
Epilepsy has different etiologies, comorbidities, and structural foci
.
Recent studies have shown that these distinctions are critical for understanding their health implications, as epilepsy has a greater physical and neuropsychiatric impact than epilepsy has on prognosis
.
For example, recent studies have found that epilepsy caused by traumatic brain injury (TBI), known as posttraumatic epilepsy (PTE), is associated with a previously unreported quality of life (QOL)
.
Just as PTE may cause additional QOL effects, other considerations, such as response to antiepileptic drugs (ASM), can alter physical and mental health in specific ways
.
For example, patients with drug-resistant epilepsy have higher rates of physical injury and mortality, cognitive impairment, and psychiatric symptoms compared with patients with non-resistant epilepsy
.
However, little is known about how DRE, PTE, and other physiological/neuropsychiatric disorders interact and regulate quality of life
.
A better understanding of the factors that influence quality of life with PTE is essential to facilitate efforts to identify individuals at greatest risk for poor quality of life, and to identify effective interventions to mitigate/prevent adverse health conditions and/or quality of life
.
For example, patients with drug-resistant epilepsy (DRE) have higher rates of physical impairment and mortality, cognitive impairment, and psychiatric symptoms compared with patients with non-drug-resistant epilepsy (DRE)
.
However, little is known about how DRE, PTE, and other physiological/neuropsychiatric disorders interact and regulate quality of life
.
A better understanding of the factors that influence quality of life with PTE is essential to facilitate efforts to identify individuals at greatest risk for poor quality of life, and to identify effective interventions to mitigate/prevent adverse health conditions and/or quality of life
.
.
For example, patients with drug-resistant epilepsy (DRE) have higher rates of physical impairment and mortality, cognitive impairment, and psychiatric symptoms compared with patients with non-drug-resistant epilepsy (DRE)
.
However, little is known about how DRE, PTE, and other physiological/neuropsychiatric disorders interact and regulate quality of life
.
A better understanding of the factors that influence quality of life with PTE is essential to facilitate efforts to identify individuals at greatest risk for poor quality of life, and to identify effective interventions to mitigate/prevent adverse health conditions and/or quality of life
.
Quality of life is a complex concept that involves a person's assessment of their life within their value system and cultural context, and is influenced by personal standards, expectations, goals, and concerns
.
Assessments of quality of life can be general or specific
.
For example, epilepsy-specific measures have been used to quantify the effects of medication, seizure worry, mood, and functional status in patients with epilepsy (PWE), but these measures may not address the broader complexities of quality of life
.
Here, we report the impact of different epilepsy phenotypes on quality of life in veterans with a high incidence of traumatic brain injury (TBI) after 9/11
.
.
Assessments of quality of life can be general or specific
.
For example, epilepsy-specific measures have been used to quantify the effects of medication, seizure worry, mood, and functional status in patients with epilepsy (PWE), but these measures may not address the broader complexities of quality of life
.
Here, we report the impact of different epilepsy phenotypes on quality of life in veterans with a high incidence of traumatic brain injury (TBI) after 9/11
.
Here, we report the impact of different epilepsy phenotypes on quality of life in veterans with a high incidence of traumatic brain injury (TBI) after 9/11
.
This observational cohort study from the Veterans Health Administration included veterans with epilepsy after the events of 9/11
.
A combination of epilepsy identification algorithms, chart extraction, and self-report measures were used to divide patients into four groups: 1.
Drug-controlled epilepsy; 2.
Drug-resistant epilepsy (DRE); 3.
Post-traumatic epilepsy (PTE); or 4.
Drug-resistant posttraumatic epilepsy (PT-DRE)
.
Adjusted for age, sex, and number of comorbidities, total scores for six quality-of-life measures were compared across groups
.
.
A combination of epilepsy identification algorithms, chart extraction, and self-report measures were used to divide patients into four groups: 1.
Drug-controlled epilepsy; 2.
Drug-resistant epilepsy (DRE); 3.
Post-traumatic epilepsy (PTE); or 4.
Drug-resistant posttraumatic epilepsy (PT-DRE)
.
Adjusted for age, sex, and number of comorbidities, total scores for six quality-of-life measures were compared across groups
.
- A total of 529 patients with epilepsy were included in the analysis: 249 controls (ie, patients with epilepsy without DRE or PTE), 124 patients with DRE, 86 patients with PTE, and 70 patients with PT-DRE
. - Drug-resistant epilepsy was more common in patients with PTE than nontraumatic epilepsy (45% vs 33%, odds ratio 1.
6 (95% CI: [1.
1-2.
4], p=0.
01))
. - In health records, patients with PTE and PT-DRE had more comorbidities than those with nontraumatic epilepsy
.
Patients with both PTE and DRE reported the lowest quality of life of all six measures, which persisted after adjustment for comorbidities and further linear analyses
.
.
.
6 (95% CI: [1.
1-2.
4], p=0.
01))
.
6 (95% CI: [1.
1-2.
4], p=0.
01))
.
.
Patients with both PTE and DRE reported the lowest quality of life of all six measures, which persisted after adjustment for comorbidities and further linear analyses
.
.
Patients with both PTE and DRE reported the lowest quality of life of all six measures, which persisted after adjustment for comorbidities and further linear analyses
.
In PTE patients, the prevalence of DRE was significantly higher than in nontraumatic epilepsy patients
.
PTE was also associated with a higher burden of comorbidities and worse overall quality of life compared with nontraumatic epilepsy patients
.
PTE patients are significantly susceptible to comorbidities associated with traumatic brain injury and epilepsy
.
This high-risk group should be the focus of future research aimed at elucidating factors associated with adverse health outcomes and developing antiepileptic therapies
.
.
PTE was also associated with a higher burden of comorbidities and worse overall quality of life compared with nontraumatic epilepsy patients
.
PTE patients are significantly susceptible to comorbidities associated with traumatic brain injury and epilepsy
.
This high-risk group should be the focus of future research aimed at elucidating factors associated with adverse health outcomes and developing antiepileptic therapies
.
Source: Gugger JJ, Kennedy E, Panahi S, et al.
Multimodal Quality of Life Assessment in Post-9/11 Veterans With Epilepsy: Impact of Drug Resistance, Traumatic Brain Injury, and Comorbidity [published online ahead of print, 2022 Apr 6].
Neurology.
2022; 10.
1212/WNL.
0000000000200146.
doi: 10.
1212/WNL.
0000000000200146
Multimodal Quality of Life Assessment in Post-9/11 Veterans With Epilepsy: Impact of Drug Resistance, Traumatic Brain Injury, and Comorbidity [published online ahead of print, 2022 Apr 6].
Neurology.
2022;10.
1212/WNL.
0000000000200146.
doi:10.
1212/WNL.
0000000000200146 Gugger JJ, Kennedy E, Panahi S, et al.
Multimodal Quality of Life Assessment in Post-9/11 Veterans With Epilepsy: Impact of Drug Resistance, Traumatic Brain Injury, and Comorbidity [published online ahead of print, 2022 Apr 6].
Neurology.
2022;10.
1212/WNL.
0000000000200146.
doi:10.
1212/WNL.
0000000000200146Gugger JJ, Kennedy E, Panahi S, et al.
Multimodal Quality of Life Assessment in Post-9/11 Veterans With Epilepsy: Impact of Drug Resistance, Traumatic Brain Injury, and Comorbidity [published online ahead of print, 2022 Apr 6].
Neurology.
2022;10.
1212/WNL.
0000000000200146.
doi:10.
1212/WNL.
0000000000200146Leave
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