Quality of life and mood assessment in conservatively treated cavernous malformation-related epilepsy

Abstract

Background: To estimate the quality of life, anxiety, depression, and illness perception in patients with medically treated cerebral cavernous malformation (CCM) and associated epilepsy.

Methods: Nonsurgically treated patients with CCM-related epilepsy (CRE) were included. Demographic, radiographic, and clinical features were assessed. All participants received established questionnaires (short-form 36 health survey, SF-36; hospital anxiety and depression score, HADS-A/D; visual analogue scale score, VAS) assessing the functional and psychosocial burden of disease. To some extent, calculated values were compared with reference values from population-based studies. Test results were related to seizure control.

Results: A total of 37 patients were included. Mean age was 45.8 ± 14.4 years, and 54.1% were female. Diagnosis of CRE was significantly associated with attenuated quality of life and increased level of anxiety, affecting physical and psychosocial dimensions. The assessment of illness perception identified considerable burden. HADS was significantly associated with VAS and SF-36 component scores. Efficacy of antiepileptic medication had no restoring impact on quality of life, anxiety, depression, or illness perception.

Conclusions: CRE negatively influences quality of life and mood, independent of seizure control due to antiepileptic medication. Screening for functional and psychosocial deficits in clinical practice might be useful for assessing individual burden and allocating surgical or drug treatment.

Keywords: anxiety; cerebral cavernous malformation; depression; epilepsy; quality of life.

FIGURE 1

Short Form‐36 (SF‐36) domains including physical health, mental health, and component scores. Physical functioning (PF), social functioning (SF), role limitations due to physical problems (RP), role limitations due to emotional problems (RE), mental health (MH), vitality (VT), bodily pain (BP), and general health perceptions (GH), physical health score (PCS), mental health score (MCS). Asterisks indicate statistical significance compared to reference population (unpaired‐t‐test)

FIGURE 2

Short Form‐36 (SF‐36) component score, hospital anxiety, and depression rating scale (HADS‐A/D) score and visual analogue scale (VAS) score assessment in patients with seizure control for (A1) 6, (A2) 12, or (A3) 24 or in patients with (B) seizure multiplicity. Unpaired t‐test was applied Abbreviations: MCS, mental health score; ns, not significant; PCS, physical health score

FIGURE 3

Correlation between time since epilepsy onset and testing and Short Form‐36 (SF‐36) component scores, hospital anxiety, and depression rating scale (HADS‐A/D) scores or visual analogue scale (VAS) scores. Linear regression analyses were applied Abbreviations: MCS, mental health score; PCS, physical health score