Abstracts

Rationale: Epilepsy and Intellectual Disability (ID) independently affect children's quality of life (QOL). It is possible that seizure freedom is associated with fewer improvements in QOL in children with ID. This study examined QOL changes after epilepsy surgery in children with and without ID to explore the hypothesis that more improvements would be seen in children without ID. Methods: QOL was measured using the QOLCE, a parent-report questionnaire for children with epilepsy; this questionnaire has 16 subscales reflecting different aspects of QOL. Scores were available for 37 children before and one year after surgery. Ten had an IQ of 70 or less (ID group). There were no differences between the two IQ groups on sex, handedness, age of seizure onset, and number of antiepileptic drugs. 27 of the children were seizure-free at follow-up (ID=7, non-ID=20). Results: Children with ID had poorer QOL in the Attention/Concentration, Behavior, Social Activities and Other Cognitive subscales of the QOLCE. When examining all children irrespective of IQ and seizure outcome, improvements in QOL after surgery were found for the following scores: Energy/Fatigue, Other Cognitive, Depression, Anxiety, Control/Helplessness, Social Interactions, Social Activities, Stigma, General Health, and overall QOL. Better QOL was found in the seizure-free children in the Social Interactions, Social Activities, General Health, and Overall QOL subscales. Examination of change in QOL after surgery considering both IQ status and seizure freedom found significant improvement only in the Behaviour scale; this improvement was greater for the seizure free- children and for those in the non-ID group. Conclusions: The results suggest that in the first year following epilepsy surgery, many aspects of QOL show improvements, not all of which are linked to seizure freedom. Children without ID experience improvements in limited aspects of QOL compared with children with higher IQ. Changes in behaviour appear to be linked to seizure freedom and higher IQ.