Quality of life in patients with epilepsy and impact of treatments.

Epilepsy is a chronic condition with numerous social and psychological consequences. This work aimed to review available data on epilepsy and the impact of surgical and pharmaceutical treatments on the quality of life in adults and children. Research on quality of life in epilepsy is characterised by a wide and fragmentary range of methodology, both in terms of study design and instruments used. Quality of life is worse in patients with epilepsy than in the general population; it is comparable or worse in patients with epilepsy than that in patients with other chronic conditions; and it is similar to that of healthy persons when patients with epilepsy are well-controlled. Frequency of seizures seems to be one of the most relevant determinants of poor quality-of-life (QOL) scores, and quality of life is worsened by the co-existence of depression. The impact of surgical treatment on quality of life is positive, in all ages, in correlation with seizure control. There is no exhaustive or even contradictory results available concerning the impact of drug treatment. Role activities, emotional status and cognition have been the most investigated domains of quality of life in epilepsy research. There is a substantial lack of information regarding the functional status domain. At present, quality of life and psychosocial functioning in people with epilepsy have been investigated in many studies. Nevertheless, the lack of a standardised approach makes it extremely difficult to summarise and indicate what measures should be used, in which patients, and in which sub-populations. In the pursuit of developing valid, reliable and sensitive measures of quality of life, it seems no longer appropriate to consider seizure frequency alone.