Quality of life issues in Epilepsy

Dr. Ashis Datta, Consultant Neurologist, In-charge, Epilepsy and Electrophysiology division, Institute of Neurosciences, Kolkata

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Published: Oct 5, 2020 02:07:56 PM IST
Updated: Oct 5, 2020 05:27:12 PM IST

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Quality of life (QOL) measures have gotten progressively significant in the determinant of the health status of patients with constant ailments as opposed to estimates, for example, recurrence and seriousness of the infection alone. Report from studies conducted among patients with epilepsy shows that the presence of mental complexities, higher seizure recurrence, sort of seizure and its seriousness, longer length of seizure, number of antiepileptic medications, sexual orientation, and an impeded financial status predicts low score on QOL instrument.

Individuals with epilepsy have impedance in quality of life (QOL) because of impact of epilepsy on different parts of their life and the medication impacts. They are prone to have poorer self-esteem, higher levels of anxiety, and depression. They are more likely to be underemployed or unemployed with lower rates of marriage and greater social isolation.

The influence of epilepsy on quality of life can be summarized in the following:

Stigma and misconception

Misconception, myths and stereotypes are as yet predominant in media depictions of epilepsy despite advances in education. Media depictions are regularly misinformed by ancient myths that consider being with epilepsy as being controlled by evil spirits, foaming at the mouth, brutal and needing dire clinical consideration. Negative mentalities in the public eye have made fear and stigma. The stigma of epilepsy can regularly be more crippling for patients with epilepsy than introducing side effects. Hence people with epilepsy cover their condition or are disengaged inside their family trying to decrease the social shame related with the turmoil and to increment conjugal possibilities.

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Psychological factors: Anxiety and depression

Both anxiety and depression are common comorbid features in PWE yet psychopathology is undertreated and under diagnosed. Depression and seizure stress were discovered to be the most persuasive indicators of quality of life in individuals with intractable epilepsy. Surgery has been appeared to fundamentally decrease nervousness and increment quality of life in patients who have become seizure free. Seizure related factors, for example, period of beginning, seizure type, recurrence, seriousness, length, fundamental etiology and hard to control seizures all impact on the prevalence of depression and anxiety

Dispositional factors: Self-esteem and sense of mastery

Unpredictability is central to living with epilepsy. Individuals may not know when a seizure will occur and often have difficulty accepting living with a chronic condition that may or may not improve. This can cause patients with epilepsy to feel that they lack control over their life, can lower mood and heighten feelings of anxiety. This has been reflected in research where patients with epilepsy demonstrate a lower sense of mastery in relation to healthy controls. Low self-esteem is commonly reported in PWE and is often mediated by employability, with those being unemployed reporting poorer self-esteem.

Social factors: Social isolation and relationships

Epilepsy has been appeared to decrease open doors for social collaboration and patients with epilepsy can disengage themselves because of a paranoid fear of having a seizure in public and the injury this may cause. A decrease in social life has many perplexing outcomes regarding social help. Social help can be a defensive factor in supporting patients with epilepsy to adapt to living with a chronic condition.

Education & employment

Children with epilepsy have been shown to underachieve at school in comparison to their peers and are more prone to educational difficulties. These difficulties may arise as a consequence of a number of factors. Drug therapy and post ictal confusion may slow cognitive functioning and impact on children’s capacity to learn. Patients with epilepsy and those who have a history of epilepsy are prohibited by law from a variety of occupations. Practices that discriminate against people with epilepsy are another major contributing factor to unemployment.

Clearly enhancements in medical interventions and diagnostic procedures will have significant ramifications for the management, anticipation and psychosocial result of epilepsy and in turn improve quality of life.

Disclaimer: The views, suggestions and opinions expressed here are the sole responsibility of the experts. No Forbes India journalist was involved in the writing and production of this article.

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