Carpay H A, Arts W F
Westeinde Hospital, Department of Child Neurology, Den Haag, The Netherlands.
Epilepsy Res. 1996 Jul;24(3):127-36. doi: 10.1016/0920-1211(96)00013-7.
During the past decade, several scales have been developed to improve the assessment of outcome in epilepsy. These scales were developed for adults and their reliability, validity and usefulness have been established. However, there is also a need for alternative measures of outcome in childhood epilepsy, especially a measure of seizure severity (SS) and measures pertaining to quality of life (QoL). Four of these adult scales are reviewed and compared to examine their applicability in childhood epilepsy. Two important methodological differences between them are discussed: (a) patient self-report vs. physician-based scales and (b) generic vs. disease-specific instruments. QoL in epilepsy is briefly reviewed. Severity of seizures and severity of side-effects are relatively neglected areas of importance to QoL in epilepsy. The existing instruments for adults are not appropriate for children in their present form. Some specific methodological issues, which are relevant for the development of scales for children with epilepsy, are subsequently discussed. New scales pertaining to physical and psychosocial aspects of QoL in childhood epilepsy are being developed. In the near future, data on their reliability, validity and usefulness will become available. A combination of scales focusing on specific aspects of QoL, including SS and severity of adverse effects, and more traditional clinical data may provide a more complete assessment of outcome in childhood epilepsy.
在过去十年间，已经开发了几种量表来改进癫痫预后的评估。这些量表是针对成年人开发的，其可靠性、有效性和实用性已经得到确立。然而，儿童癫痫的预后也需要有替代评估方法，特别是癫痫发作严重程度（SS）的测量方法以及与生活质量（QoL）相关的测量方法。本文回顾并比较了其中四种成人量表，以考察它们在儿童癫痫中的适用性。讨论了它们之间两个重要的方法学差异：（a）患者自我报告量表与基于医生的量表；（b）通用量表与疾病特异性工具。简要回顾了癫痫的生活质量。癫痫发作的严重程度和副作用的严重程度是癫痫生活质量中相对被忽视但很重要的领域。现有的成人量表目前的形式不适用于儿童。随后讨论了一些与开发儿童癫痫量表相关的具体方法学问题。目前正在开发与儿童癫痫生活质量的身体和心理社会方面相关的新量表。在不久的将来，有关其可靠性、有效性和实用性的数据将会可得。综合关注生活质量特定方面（包括癫痫发作严重程度和不良反应严重程度）的量表以及更传统的临床数据，可能会对儿童癫痫的预后提供更全面的评估。
