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Summary An open, prospective, observational study was performed to assess efficacy and adverse-event profile of topiramate as add-on therapy in epilepsy. Outpatient neurology clinics from 11 general hospitals in Greece participated in the study. In total, 211 patients with treatment resistant partial-onset seizures who met the inclusion criteria, were studied. After baseline evaluation, topiramate was given at a target dose of 200mg/day over a 1-month titration period. In the subsequent maintenance period, the topiramate dose could be varied according to the clinical results. Patients were followed for in total 6 months, with monthly visits and regular physical, neurological and laboratory examinations. Seizure frequencies decreased to 35–40% of baseline values following 3 months of treatment and remained relatively constant thereafter. The average monthly seizure frequency over the 6-month study period was 4.61, compared to 9.21 at baseline. The number of responders (patients with at least 50% reduction in seizure frequency) followed a similar pattern, i.e., increase during the first 3 months levelling off at a final 80–85% response rate. Of those completing the study, 30% had been seizure-free for at least 3 months and 12% for 5 months. Topiramate was well tolerated, no deviations in laboratory values were found. Adverse events appeared to occur less frequently, and antiepileptic effects were more pronounced in this prospective open-label study than in earlier reports from randomised controlled trials. The nature of the patient population and the application of individualised dose optimisation are proposed as contributing factors to explain the favourable results of this study.

The aim was to study the influence of patients’ age, frequency and type of seizures, disease duration, number of AEDs and use of benzodiazepines on the quality of life of patients with epilepsy. We consecutively identified 223 patients with epilepsy who attended the epilepsy outpatient clinics at three university hospitals in Greece. Quality of life was evaluated by QOLIE-31. One-way analysis was used to assess the association of the studied factors and QOLIE-31 subscales. After checking for co-linearity, we performed multivariate stepwise linear regression analysis with all the variables that on univariate analysis showed a statistically significant effect on each subscale of QOLIE-31 to explore which of the studied factors affect independently on QOLIE-31 scores. Of a total of 223 patients, 118 (52.95%) were men; mean age was 35.18 ± 13.22; mean duration of the disease was 13 years; 58 (26%) patients had generalized seizures, 93 (41.7%) had PS, and 72 (32.3%) of the patients had PsG; 85 (38.1%) were on polytherapy and 38 (17%) were taking benzodiazepines. Independent factors affecting QoL were: seizure frequency (Overall QoL P = 0.0001, Seizure worry and Emotional well-being P

This study is presenting the translation and cultural adaptation into Greek of the Quality of Life in Epilepsy Inventory (QOLIE-31). We adapted the QOLIE-31 to Greek through a procedure of translation-back-translation. Sixty-three patients were interviewed and completed the QOLIE-31 and the GHQ questionnaires. We re-examined a subset of them after a period of 2-5 weeks to evaluate the test-retest reliability of the questionnaire. We assessed the convergent validity by comparison of the QOLIE-31 and the GHQ and QOLIE-31 subscales and external measures. Discriminative validity was evaluated using the method of known-groups comparisons. The internal consistency was high for the QOLIE-31 and its' subscales (Cronbach's alpha 0.92 and 0.59-0.83 respectively). Test-retest reliability was acceptable (intra-class correlation coefficient 0.49-0.89 and Pearson's coefficient 0.53-0.92) for the group of patients who were re-examined. Comparison of the QOLIE-31 and GHQ scores showed agreement between the two questionnaires (Pearson's coefficient -0.61). We demonstrated the discriminative validity by the difference in the QOLIE-31 scores between patients with different seizure frequencies and different employment status. We concluded that the Greek version of the QOLIE-31 has psychometric properties equivalent to those of the original American-English version and is a valid and reliable instrument.

SummaryThe frequency of sleep disturbances in patients with epilepsy and their impact on quality of life (QoL) have been documented in a few reports, and the results are conflicting. We identified 124 consecutive epilepsy out-patients who visited the epilepsy out-patient clinics at the University Hospital of Alexandroupolis, the AHEPA Hospital in Thessaloniki and the Aeginitio Hospital in Athens. We measured excessive daytime sleepiness (EDS) with the Epworth Sleepiness Scale (ESS), obstructive sleep apnea (OSA) with the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ), and insomnia with the Athens Insomnia Scale (AIS). We evaluated quality of life by the Quality of Life in Epilepsy Inventory (QOLIE-31). EDS was found in 16.9% (21/124) of epileptic patients, OSA in 28.2% (35/124), and insomnia in 24.6% (30/122). In multivariate analysis, we found that insomnia was an independent negative factor for Total score (p