O'Donoghue, Michael Francis;
(2000)
The measurement of outcome in the treatment of epilepsy.
Doctoral thesis (Ph.D.), University College London (United Kingdom).
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Abstract
Seizure frequency has until recently been the usual measure of efficacy of epilepsy treatment. The aims of this thesis were to develop and implement two new outcome measures of epilepsy therapy. A new seizure severity scale and a measure of the handicap associated with epilepsy were designed and evaluated. The psychosocial burden of epilepsy was assessed in an unselected population using the new measure of handicap. The benefits of epilepsy surgery and programs of comprehensive epilepsy assessment were investigated in patients with intractable seizures. The new seizure severity scale was found to be reliable and to have construct validity. It is now in use in international antiepileptic drug trials. The Subjective Handicap of Epilepsy scale (SHE) was found to be a reliable and valid measure of the impact of epilepsy on the life of an individual with epilepsy. In a unselected community-based sample of persons with epilepsy, the severity of subjective handicap was related to seizure frequency and to the duration of remission of epilepsy. A third of persons with active epilepsy were found to be significantly handicapped by their condition. Between a third and a half of subjects had psychiatric symptoms. Scores on a measure of general health indicated that active seizures and drug treatment both had detrimental effects on well-being. In a longitudinal observational study, significant improvements in seizure control, subjective handicap, quality of life and psychiatric status were seen in 42 surgically treated patients compared with 82 subjects assessed for surgery but not operated upon. Compared with control groups, 67 patients who underwent a program of comprehensive assessment improved on some measures of quality of life and handicap. Remission of seizures had a primary role in achieving a major reduction in handicap and gains in quality of life.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D. |
| Title: | The measurement of outcome in the treatment of epilepsy |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Thesis digitised by ProQuest. |
| Keywords: | (UMI)AAIU145712; Biological sciences; Psychology |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10103605 |
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