Department of Pediatrics, Schulich school of Dentistry and Medicine, Western University, London, ON, Canada; Children's Health Research Institute, Lawson Health Research Institute, London, ON, Canada.
Children's Health Research Institute, Lawson Health Research Institute, London, ON, Canada; Epidemiology and Biostatistics, Western University, London, ON, Canada.
Seizure. 2022 Jul;99:120-126. doi: 10.1016/j.seizure.2022.05.012. Epub 2022 May 18.
Health-related quality of life (HRQL) is compromised in children with epilepsy. We aimed to determine whether children diagnosed with epilepsy between ages 4-12 years who are exposed to a higher number of anti-seizure medication (ASM) over the first 2 years, have poorer HRQL 10 years after diagnosis.
Data were obtained from 195 children enrolled in the Health-Related Quality of Life in Children with Epilepsy Study (HERQULES) in Canada. HRQL was measured using the Quality of Life in Childhood Epilepsy Questionnaire (QOLCE-55) completed by parents at baseline through to 10 years after diagnosis. The total number of ASM were reported by physicians four times in the first two years after diagnosis. Multivariable block-wise linear regression was used to assess the impact of ASM (categorized as none, one, or more than one), as well as clinical and family factors on children's HRQL 10 years after diagnosis.
Children had a mean age of 7.9 ± 2.3 years at diagnosis and 92 (47%) were female. Mean QOLCE at baseline and 10 years was 72.04±14 and 78.7±16,respectively. Clinically meaningful improvement in HRQL from the 2 to 10-year follow-up was detected in 35% of children, reported similarly across all ASM treatment categories (p = .38). The number of ASM prescribed in the first two years was associated with HRQL at the 10-year follow-up, however this association was not significant when adjusting for clinical characteristics, family factors, and HRQL at the two-year follow-up (p = .75). Our data showed that HRQL at 2 years was the only variable associated with better HRQL scores at 10 years (p = <.001).
In children with new onset epilepsy, exposure to a higher number of ASM, when accounting for clinical and family factors as well as HRQL at 2 years, is not independently associated with lower long-term HRQL. Early HRQL was found to be a good indicator of long-term HRQL, despite the number of ASMs prescribed.
患有癫痫的儿童的健康相关生活质量（HRQL）受损。我们旨在确定在 4-12 岁之间被诊断患有癫痫的儿童，在最初的 2 年内接触到更多的抗癫痫药物（ASM），是否会在诊断后 10 年内 HRQL 更差。
数据来自加拿大健康相关生活质量癫痫儿童研究（HERQULES）中纳入的 195 名儿童。HRQL 通过父母在基线至诊断后 10 年期间使用生活质量在儿童癫痫问卷（QOLCE-55）进行测量。医生在诊断后的头两年内四次报告 ASM 的总数。采用多元块线性回归评估 ASM 的数量（分为无、一或多）以及临床和家庭因素对儿童诊断后 10 年 HRQL 的影响。
儿童诊断时的平均年龄为 7.9 ± 2.3 岁，92 名（47%）为女性。基线和 10 年时的 QOLCE 平均值分别为 72.04±14 和 78.7±16。从第 2 年到第 10 年的随访中，35%的儿童的 HRQL 有临床意义的改善，所有 ASM 治疗类别报告的结果相似（p=0.38）。在最初的两年内开处方的 ASM 数量与 10 年时的 HRQL 相关，但在调整临床特征、家庭因素和两年时的 HRQL 后，这种相关性没有统计学意义（p=0.75）。我们的数据表明，2 年时的 HRQL 是与 10 年时更好的 HRQL 评分相关的唯一变量（p<0.001）。
在新诊断为癫痫的儿童中，在考虑临床和家庭因素以及 2 年时的 HRQL 后，接触更多的 ASM 与长期 HRQL 较低无关。尽管处方的 ASM 数量不同，但早期 HRQL 是长期 HRQL 的良好指标。
