Evaluation of quality of life's prognostic factors in people with functional seizures

Abstract

Aims: Functional non-epileptic seizures significantly impact the quality of life of patients. We aimed to identify prognostic factors associated with the quality of life in individuals with functional non-epileptic seizures.

Subjects and methods: Adult patients diagnosed with definite or documented functional seizures based on LaFrance's criteria (n=72) were enrolled at the time of diagnosis. Quality of life was assessed using the Quality of Life in Epilepsy Inventory-31 (QOLIE-31) at diagnosis and at a six-month follow-up. Demographic and medical information was collected, and psychiatric comorbidities were evaluated using validated scales.

Results: Comparisons between diagnosis and follow-up did not reveal any factors associated with improvement in quality of life at six months after diagnosis. However, multivariable analysis, adjusted for age, sex, diagnosis delay, and frequency of functional seizures showed a significant cross-sectional relationship with a QOLIE-31 score decrease of 0.66 [95% CI -0.93;-0.39], -0.32 [-0.61; -0.03], and -0.22 [-0.42; -0.02] for an increase of 1 point of BDI-2 score, BAI score, and CTQ score respectively.

Conclusion: Psychiatric comorbidities, particularly depression and anxiety, are associated with worse quality of life in patients with functional seizures. This underscores the crucial importance of multidisciplinary care involving both neurological and psychiatric expertise when managing individuals with functional seizures.

Keywords: Anxiety; Depression; Functional seizures; Psychogenic non-epileptic seizures; Quality of life.