Behandlungserfolg bei station?ren Patienten in diakonischen Epilepsiezentren

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• 作者：Prof. Dr. T.W. May ; M. Pf?fflin ; S. Brückner ; M.T. Lutz…
• 关键词：Epilepsie ; Anf?lle ; Lebensqualit?t ; Beeintr?chtigungen ; Therapieresistenz ; Epilepsy ; Seizures ; Quality of life ; Impairment ; Treatment resistance
• 刊名：Zeitschrift f篓鹿r Epileptologie
• 出版年：2015
• 出版时间：February 2015
• 年：2015
• 卷：28
• 期：1
• 页码：49-60
• 全文大小：984 KB
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• 刊物主题：Neurology;
• 出版者：Springer Berlin Heidelberg
• ISSN：1610-0646

文摘

Background Diaconal epilepsy centers are highly specialized in comprehensive care of patients with difficult-to-treat epilepsies, comorbidities, multiple handicaps and psychosocial problems. Aims The primary objective of this study was to investigate the effects of the comprehensive treatment of the four participating epilepsy centres. Material and methods This was a multicenter, prospective study using a pre-post design. The patients were asked to complete a questionnaire before admission to the centre and 6 months after discharge. The data of 196 patients were analyzed. Primary outcome measures were seizure frequency, tolerability of antiepileptic drugs, overall quality of life and epilepsy-related fears which were assessed using the Performance, Socio-demographic aspects, Subjective evaluation (PESOS) questionnaire and questions of the quality of life in epilepsy inventory 31 (QOLIE-31). Non-parametric tests were used for statistical analysis. Results and conclusions Significant improvements (p--.01 after adjustment for alpha error) were confirmed for all primary outcome measures 6 months after discharge compared to the baseline before admission. Significant improvements were also reported in global health, felt stigma, anxiety and depression. The rate of patients who were seizure-free in the past 6 months increased from 7.1- to 26.6- while the rate of patients with at least one seizure per month decreased from 55.4- to 33.2-. Predictors of clinically relevant seizure reduction were the number of different seizure types and the number of antiepileptic drugs (AED) at admission. Conclusion Patients with difficult-to-treat, long-lasting epilepsy, comorbidities and psychosocial problems should be referred to a specialized epilepsy centre to obtain most benefits.