Return to driving after a diagnosis of epilepsy: A prospective registry study

Xu, Ying; Hackett, Maree L.; Glozier, Nick; Nikpour, Armin; Somerville, Ernest; Bleasel, Andrew; Ireland, Carol A.; Anderson, Craig S.

doi:10.1111/epi.14001

Cited by 8 publications

(3 citation statements)

References 27 publications

(77 reference statements)

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“…Data are from the Sydney Epilepsy Incidence Study to Measure Illness Consequences (SEISMIC), a prospective multicenter, communitybased study of people with newly diagnosed epilepsy in the metropolitan region of Sydney, Australia. The study is registered (ANZCTRN12609000059268) and outlined in detail elsewhere [16][17][18]. In brief, participants of all ages with a new diagnosis of epilepsy according to centrally adjudicated, standard criteria, were enrolled over an initial 6-month pilot phase from July 2008.…”

Section: Methodsmentioning

confidence: 99%

Disability patterns over the first year after a diagnosis of epilepsy

Neuen

Glozier

et al. 2019

Clinical Neurology and Neurosurgery

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2019) Disability patterns over the first year after a diagnosis of epilespy. Clinical Neurology and Neurosurgery, 179,[60][61][62][63][64][65] Objective: To determine the patterns and predictors of disability over the first 12 months after a diagnosis of epilepsy. Patients and methods: The Sydney Epilepsy Incidence Study to Measure Illness Consequences (SEISMIC) was a prospective, multicenter, community-based study of people with newly diagnosed epilepsy in Sydney, Australia. Disability was assessed using the World Health Organization's, Disability Assessment Schedule (WHODAS) 2.0 12-item version, at baseline (i.e. within 28 days of diagnosis) and 12 months post-diagnosis. Demographic, socioeconomic, clinical and epilepsy-related data, obtained through structured interviews, were entered into multivariable linear regression and shift analysis to determine predictors of greater disability. Results: Of 259 adults (≥18 years), 190 (73%) had complete WHODAS at baseline (mean ± SD scores 4 ± 6) and follow-up (4 ± 8). After adjustment for age, sex and co-morbidity, greater overall disability at 12 months was associated with lower education (P = 0.05), economic hardship (P = 0.004), multiple antiepileptic medications (P = 0.02) and greater disability (P < 0.001) at the time of diagnosis; these variables explained 38.3% of the variance. Among the 12 WHODAS items, "being emotionally affected by health problems" was the most frequent disability problem identified at both time points (all P < 0.0001). The proportion of participants without problems in that domain improved over 12 months (from 24% to 50%, P < 0.0001), whereas the other 11 items remained relatively stable. Independent baseline predictors of a worse emotional outcome at 12 months were severe/extreme emotional distress (odds ratio [OR] 4.52, 95% confidence intervals [CI] 1.67-12.24), economic hardship (OR 2.30, 95% CI 1.24-4.25) and perceived stigma (OR 2.02, 95% CI 1.03-3.93). Conclusion: Most people report problems with emotional health after a diagnosis of epilepsy but many recover over the next 12 months. Services addressing the social and psychological impact of diagnosis may be needed to improve outcome.

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Section: Methodsmentioning

confidence: 99%

Disability patterns over the first year after a diagnosis of epilepsy

Neuen

Glozier

et al. 2019

Clinical Neurology and Neurosurgery

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“…SEISMIC is registered on the Australia New Zealand Clinical Trial Registration database, and the protocol and main results are published [14][15][16][17]. In brief, people of all ages with a new diagnosis of epilepsy were identified and enrolled through a geographically based multi-site ascertainment process in Sydney, Australia from July 2008 to December 2013.…”

Section: Study Design and Patientmentioning

confidence: 99%

Course and impact of sleep disturbance in newly diagnosed epilepsy: A prospective registry study

Hackett

Nikpour

et al. 2020

Clinical Neurology and Neurosurgery

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Objective: To determine the course of sleep distrurbance (insomnia symptoms and short sleep duration) after a diagnosis of epilepsy and their associations with seizure control, mood, disability, and quality of life. Patients andMethods: One hundred and sixty-nine adults were drawn from the Sydney Epilepsy Incidence Study to Measure Illness Consequences (SEISMIC), a prospective, multicenter, community-wide study in Sydney, Australia. Sociodemographic, psychosocial, clinical characteristics, and information on sleep disturbance were obtained early (median 48 [IQR15-113] days) after a diagnosis of epilepsy, and at 12 months. Logistic regression models were used to determine associations between patterns of sleep disturbance with outcomes at 12 months. Results: Insomnia symptoms and/or short sleep duration were present in 18-23% of participants at both time points, with over half (54-61%) showing a chronic pattern. There was no association of sleep disturbance pattern with recurrent seizures, medication use or disability. Chronic insomnia symptoms and short sleep duration were strongly associated with worse mental health (aOR 3.76, 95% CI 1.28-11.06; and aOR 5.41, 95% CI 1.86-15.79) and poorer quality of life at 12 months (aOR 3.02, 95% CI 1.03-8.84; and aOR 3.11, 95% CI 1.10-8.82), after adjusting for clinical features of epilepsy and comorbidity. Those whose sleep disturbance remitted had no adverse outcomes. Conclusions: Insomnia symptoms and short sleep duration are less common in people with recently-diagnosed than chronic epilepsy. The temporal association with poor psycholosocial outcomes supports specific interventions addressing sleep disturbance.

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“…[18] In a recent large, randomized control treatment trial, roughly 43% of patients eligible for evaluation did not engage in care for a variety of reasons. [19] Poor rates of engagement are further exacerbated by patients’ inability to drive due to seizure precautions [20] , [21] , [22] , [23] and a lack of NES disorder specific resources. [24] …”

Section: Introductionmentioning

confidence: 99%