Uijl S G, Uiterwaal C S M P, Aldenkamp A P, Carpay J A, Doelman J C, Keizer K, Vecht C J, de Krom M C, van Donselaar C A
Rudolf Magnus Institute of Neuroscience and University Medical Center Utrecht, Department of Clinical Neurophysiology, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
Seizure. 2006 Jun;15(4):242-8. doi: 10.1016/j.seizure.2006.02.009. Epub 2006 Mar 23.
Side-effects of anti-epileptic drugs (AEDs) may be overlooked in patients with epilepsy in everyday clinical practice. The aim of this study was to assess the prevalence and severity of subjective complaints in patients who were considered to be well-controlled and to assess whether these complaints are related to medication, personality traits, or other determinants.
We included patients with epilepsy who were considered to be well-controlled in a cross-sectional study in seven hospitals in the Netherlands. Their medication had not been changed for six months and an apparent reason to change the medication was lacking at the time of enrolment. Subjective complaints were assessed with a 46-item questionnaire. Using multivariable linear regression modeling, we assessed whether patient characteristics, epilepsy characteristics, medication, quality of life (Qolie-10), and personality traits (SCL-90) explained the presence and severity of complaints.
Of 173 included patients, 67% reported moderate to severe subjective complaints on the questionnaire. Cognitive complaints were reported most frequently. Multivariate modeling showed that 61% of the variance in reported complaints could be explained by included determinants. The prevalence and severity of complaints was associated with AED polytherapy and higher scores on psycho neuroticism.
Patients who were considered to be well-controlled proved to report an unexpectedly high number of subjective complaints. Both medication and aspects of personality contributed to the level of complaints. Our study illustrates that subjective side-effects are easily overlooked in everyday clinical practice, possibly because in practice a generally phrased question is used to detect side-effects.
在日常临床实践中，癫痫患者抗癫痫药物（AEDs）的副作用可能被忽视。本研究的目的是评估被认为病情得到良好控制的患者主观不适的发生率和严重程度，并评估这些不适是否与药物治疗、人格特质或其他决定因素有关。
我们在荷兰的七家医院进行了一项横断面研究，纳入了被认为病情得到良好控制的癫痫患者。他们的药物治疗在六个月内未发生变化，且在入组时缺乏改变药物治疗的明显理由。使用一份包含46个条目的问卷评估主观不适。通过多变量线性回归模型，我们评估了患者特征、癫痫特征、药物治疗、生活质量（Qolie - 10）和人格特质（SCL - 90）是否能解释不适的存在和严重程度。
在173名纳入研究的患者中，67%在问卷中报告了中度至重度的主观不适。认知方面的不适报告最为频繁。多变量模型显示，所报告不适的61%的变异可由纳入的决定因素解释。不适的发生率和严重程度与AEDs联合治疗以及较高的精神神经质得分相关。
被认为病情得到良好控制的患者报告的主观不适数量出乎意料地高。药物治疗和人格方面都对不适程度有影响。我们的研究表明，在日常临床实践中，主观副作用很容易被忽视，可能是因为在实践中使用的是一个笼统表述的问题来检测副作用。
