Determinants of quality of life in Pediatric Epilepsy: A study from a single tertiary center

Epilepsy profoundly impacts a child's Quality of Life (QoL). This study sought to identify factors affecting QoL in children with epilepsy (CWE) at a single pediatric tertiary hospital, identifying key influencing factors to guide interventions.

A cross-sectional study was conducted involving 400 CWE (5-18 years) and their caregivers using the Pediatric Quality of Life Inventory^TM (PedsQL^TM). Demographic and clinical variables were obtained. Statistical analysis was used to identify predictors of QoL.

Participants were predominantly from the MENA and South Asia regions; 59 % had epilepsy onset before age 5; 53 % were on monotherapy and 32 % were seizure-free in the prior year. Male gender and school attendance were associated with higher QoL scores. In contrast, early seizure onset, polytherapy, comorbidities, previous epilepsy surgery, and frequent seizures were linked to lower QoL scores. Domain-level analysis highlighted significant age-related declines in the cognitive functioning, sleep/fatigue, and mood/behavior domains. In multiple linear regression, older age and comorbidities independently predicted lower QoL, while school attendance predicted higher QoL. Caregiver identity also influenced scores, with mothers reporting lower QoL for their children. The model explained ∼ 38 % of the variance in parent-reported QoL. In binary logistic regression, comorbidities and mother as respondent were the strongest predictors of lower odds of favorable QoL (model fit p = 0.09; R² ≈ 0.35). For child-reported QoL, univariate associations were limited, and multivariable modeling was not performed.

QoL in CWE is influenced by both medical and psychosocial factors, emphasizing the need for holistic, individualized epilepsy care.