QUALITY OF LIFE IN PATIENTS WITH EPILEPSIA DEPENDING ON THE CSF-TO-CRANIAL VOLUME RATIO
DOI: 10.22138/2500-0918-2018-15-6-785-793
V.I. Larkin, N.S. Stelmakh, A.G. Kalinichev, A.V. Ershov
Omsk State Medical University, Omsk, Russian Federation;
V.A. Negovsky Research Institute of General Reanimatology, Moscow, Russian Federation
Abstract. Objective. To assess the quality of life of patients with an established diagnosis of epilepsy and clinical manifestations of craniocerebral disproportion with low CSF-to-cranial volume ratios. Materials and methods. In the course of the study, a comparative analysis of clinical, instrumental and laboratory research data was carried out. The case histories of 78 patients with epileptic seizures (cryptogenic epilepsy) diagnosed on the basis of typical clinical symptoms, medical history, electroencephalography dynamics and/or 10-hour video-EEG monitoring were analyzed prospectively. Group 1 consisted of 36 patients with CSF-to-cranial volume ratios (the ratio between the CSF space volume and the cranial cavity volume) within the normal physiological range (1.6–3.6, with an average value of 2.1±0.2). The patients from Group 1 underwent a standard multicomponent therapy during hospitalization and treatment in the outpatient polyclinics. Group 2 consisted of 42 patients, whose CSF-to-cranial volume ratios were outside the normal physiological limits (0.8–1.2, with an average value of 1.0±0.1), judging by a thorough anatomical examination and a comprehensive functional assessment. The main condition was also treated according to the standard scheme, which was identical to the therapy carried out in group 1. The patients' quality of life was assessed using the QOLIE-31 questionnaire (Version 1.0). The severity of depression was evaluated using the Beck Depression Inventory. The minimum duration of clinical and instrumental monitoring of patients from the time the patient was included in the study was 2 years. Results. Testing of patients according to the QOLIE-31 questionnaire after 1 and 2-year follow-up showed that, in general, the quality of life indicators remained relatively stable. The tendency to a decrease in the total score was observed in group 2 and, probably, was due to a greater severity of illness. Thus, during 2 years of follow-up, the total score decreased by 2.8% (p=0.94) in patients with normal CSF-to-cranial volume ratios. In patients with low ratios, the total score decreased by 5.6% (p=0.78) and was 8,6% lower (p=0.58) than in group 1. It was established that depressive disorders were more common in patients with a low CSF-to-cranial volume ratio (R=-0.18, p=0.047), with temporal and frontal localization of epileptic foci (G=0.35, p=0.0074), in female patients (G=0.27, p=0.023), under the age of 24 and over 37 years old (G=0.29, p=0.035), with epilepsy duration of more than 5 years (R=0.32, p=0.0091), and frequent seizures (G=0.31, p=0.0038). Conclusion. Patients with cryptogenic epilepsy and low CSF-to-cranial volume ratios in comparison with patients, whose ratios were within the normal range, often had an increased level of depression and lower quality of life indicators.
Keywords: epilepsy, CSF-to-cranial volume ratio, quality of life
There is no conflict of interest.
Contact details of the corresponding author:
Natalia S. Stelmakh
19830105@mail.ru
Received 21.12.2018
For citation:
Larkin V.I., Stelmakh N.S., Kalinichev A.G., Ershov A.V. Quality of life in patients with epilepsia depending on the CSF-to-cranial volume ratio. Vestn. Ural. Med. Akad. Nauki. = Journal of Ural Medical Academic Science. 2018, Vol. 15, no. 6, pp. 785–793. DOI: 10.22138/2500-0918-2018-15-6-785-793 (In Russ).
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Authors:
Valery I. Larkin
Dr. Sci. (Med), Assistant Professor
Omsk State Medical University
Lenin Str. 12, Omsk, Russian Federation, 644099
larkin_valery@mail.ru
Natalya S. Stelmakh
Graduate Student
Omsk State Medical University
Lenin Str. 12 Omsk Russian Federation 644099 19830105@mail.ru
Aleksey G. Kalinichev
Dr. Sci. (Med), Professor
Omsk State Medical University
Lenin Str. 12, Omsk, Russian Federation, 644099
akalinichev59@gmail.com
Anton V. Ershov
Dr. Sci. (Med), Senior Researcher
V.A. Negovsky Research Institute of General Reanimatology
Petrovka Str. 25, Moscow, Russian Federation, 107031
salavatprof@mail.ru
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)