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Optimizing health outcomes in active epilepsy

From the Adult Epilepsy Center, Department of Neurology, Washington University, St. Louis, MO.

Address correspondence and reprint requests to Dr. Frank Gilliam, Washington University Epilepsy Program, Campus Box 8111, 660 South Euclid Avenue, St. Louis, MO 63110.

Article abstract Epilepsy is a chronic condition with complex effects on a person’s social, vocational, and psychological function. Recent advances in methods and instruments to assess subjective health status and patient preferences have provided important data on health outcomes in epilepsy. For many patients that do not respond to initial trials of antiepileptic medications, epilepsy surgery is a treatment alternative that offers the possibility of complete control of seizures and improved quality of life. Adverse medication effects and depression are readily identified by systematic use of reliable and valid instruments, and may be the most important negative influences on a person’s perception of their current health status. Adequate education regarding relative risks of recurrent seizures compared to surgery, systematic screening for adverse medication effects and subsequent selection of appropriate antiepileptic drugs, and identification and treatment of depression should offer substantial improvement in overall health of persons with epilepsy.

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