A Study Of Quality Of Life In Women With Epilepsy Of Childbearing Age

Epilepsy is one of the most common chronic neurologic disorders.With the recent advancement in antiepileptic drug(AED) treatment and surgical techniques, epileptic seizures are nowadays relatively well managed.However,epilepsy can still adversely affect patients' overall health status and decrease the patients' quality of life (QOL).So far,seizure frequency,seizure types,adverse effects of AEDs and depression have been established as factors affecting the QOL or psychosocial wellbeing of the epilepsy patients.Female patients have the special cyclic change of sex serum hormones during the ovulatory menstrual cycle.Epilepsy and anticonvulsant drugs may influence the level of hormones interactionally.So female patients with epilepsies are different from the other.They maybe affront the catamenial seizures and menstrual irregularity.They should play a diverse roll from man which the whole society give them.Such as play a roll of mother to being pregnancy and bearing.So the quality of life(QOL) in women with epilepsy of childbearing age and the associated factors are different from man's.In several study, female patients with epilepsies had poorer scores on QOL,lower level of earning, worse physical condition.In the present study,we attempted to elucidate the level of QOL in women with epilepsy of childbearing age,the influential factors determining the QOL.Purpose:To investigate the features and related factors of quality of life in women with epilepsy of childbearing age.Material and Methods:We evaluated 161 women(81with epilepsies and 80 normal control) in premenopausal state aged 18 to 50.We reviewed their common instance and medical record.We exam the 161 women with a battery of questionnaires comprises QOLIE-31,side effect profile,self-rating anxiety scale(SAS) and Hamilton depression scale(HAMD) and The Arizona Sexual Experience Scale (ASEX). Results:1.Demographic and clinical characteristics of respondents:The unemployed is account for 30.9%in female patients and 1.3%in control group.32.1%female patients and 21.3%control group have no income in the recent year.27.2% female patients and 21.3%control group's family have less income than 1000 yuan in the recent year.There is no significant difference between adult patients and control group in age,education,number of family members,BMI index, marriage,and living conditions.2.Epilepsy and treatments:The seizure types of the female patients are mostly general tonic clonic seizure(GTCS)(32.1%) and complex partial seizure(CPS)(18.5%).Seizure frequency of female patients is mostly＞1 week and＜1 month(38.3%),and seizure duration of female patients is mostly＞1 minute and＜2 minutes(40.7%).Compliance rates in this study population were moderately high,with 79%of patients reporting that they never missed taking their tablets.38.3%of female patients reported at least a seizure-related injury. 4.9%of female patients have an epilepsy family history.47(58%) of patients were taking AEDs monotherapy,27(33.3%) of patients were taking AEDs polytherapy.In the 47 patients who are taking AEDs monotherapy 16(34%) are using carbamazepine(CMZ) and 13(27.7%) are using valproate(VPA).3.Medical record of gynaecology:In total 81 female patients,24of them(29.6%) have menstrual irregularity,the number in control group is 9(11.3%).Menstrual irregularity is more frequently in patients on VPA montherapy(44%) and on AEDs polytherapy(43%).The numbers in patients on CMZ montherapy and PHT montherapy are 23%and 25%.But the final conclusion has no significant difference.The reason maybe is the little statistical number.There is no significant difference between patients and control group in contraception, proportion of bearing,bearing age,bearing way,feeding way,health of children. In 28 female patients who already have epilepsy before bearing,only 10(35.7%) of them had consulted doctors before pregnancy,5(17.9%)of them was told to taking folic acid.50%patients who were taking AEDs stopped or decreased the AEDs during the pregnancy without permission.4.The feature of QOL:(1)The most common adverse effect of AEDs in female patients is unsteadiness,restlessness,feeling of aggression,nervousness and/or agitation,hireloss,double or blurred vision,difficulty in concentrating,shaky hands,dizziness,weight gain,depression,memory problem and disturbed sleep. There is significant difference between patients and control group.(2)Compared with control group,the quality of life in female patients is significantly impaired, especially in the areas of overall quality of life,cognitive and social function.(3) The female patients had significantly higher(P＜0.01) average depression scores than controls.They also had significantly higher(P＜0.01) average anxiety scores than controls.(4) We evaluated the sexual function of female patients and control group.There is significant difference between two group in the number of sexual dysfunction and the score of ASEX.5.Related factors of QOL in female patients:In this study we analyse the date of QOL and related factors collected from 81 female patients in multiple regression way at first(analysis 1).Then we analyse the date of QOL and related factors collected from 44 female patients who had complete the sexual function evaluation in the same way(analysis 2).In multiple regression analysis 1,factors affecting the QOL were:individual earning,seizure frequency,the symptoms of depression.In multiple regression analysis 2,factors affecting the QOL were:the sexual function,the adverse effects of AEDs,compliance.Conclusion:1.Female patients in pregnancy compliance became worse,they had not got enough imformation.2.Female patients have impaired QOL.3.The related factors of QOL in people with epilepsy are depression,sexual fuction,seizure frequency,the adverse effects of AEDs,individual earning compliance.