الفهرس 
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Abstract
Epilepsy is a chronic condition characterized by the recurrence of unprovoked seizures. The International League against Epilepsy (ILAE) recently defined epilepsy based on at least one of the following conditions:
(4) at least two unprovoked (or reflex) seizures occurring more than 24 hours apart.
(5) one unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next ten years.
(6) diagnosis of epilepsy syndrome.
Epilepsy is one of the common neurological disorders in adolescents worldwide. More than two million cases are diagnosed with epilepsy every year. In adolescents, the annual incidence rate of epilepsy is 5–7 per 100 000 and prevalence rate ranged from 20 to 60 per 100 000.
A significant proportion of these children will experience either anxiety or depression. The burden of psychiatric comorbidity in children and adolescents with epilepsy is significant, leading to increased morbidity and impact on patients and their families.
Quality of Life (QoL) is defined by the World Health Organization as ‘the individual’s perception of their position in life, in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards, and concerns’. It has been shown that Quality of Life (QoL) is influenced primarily by psychosocial variables and the individual’s physical and mental characteristics and cannot be attributed solely to physical health.
The goal of the treatment of epilepsy is to achieve a significant reduction in seizure frequency or complete seizure control without adverse drug reactions as well as to ensure the best Quality of Life for the child.
Our study aimed to describe social well-being and Quality of Life (QoL) in adolescents with epilepsy, explore the adolescents’ adherence to treatment and also compare the effect of mono antiepileptic therapy versus poly antiepileptic therapy.
This comparative cross-sectional study was conducted on adolescent patients with epilepsy who attended the pediatric departments of Benha University Hospital and Benha Children Hospital. Patients aged 10-18 with an average IQ of 90-110 and diagnosed with epilepsy based on history and EEG findings were included. The study included two groups: group I - adolescents with epilepsy who received mono Antiepileptic therapy, and group II - adolescents with epilepsy who received poly Antiepileptic therapy. The KIDSCREEN-27 questionnaire was used to assess quality of life, and additional data on adherence to treatment, seizure frequency, and side effects of medication were collected.
Summary of our results:
• Regarding general characteristics, no significant differences were reported between the studied groups regarding age (P = 0.865), gender (P = 1.0), birth weight (P = 0.265), weight (P = 0.826), and height (P = 0.799).
• Regarding lab findings, no significant differences were reported between the studied groups regarding TLC (P = 0.392), neutrophils (P = 0.291), lymphocytes (P = 0.383), hemoglobin level (P = 0.232), and platelets (P = 0.336).
• Regarding Seizure characteristics, the monotherapy group demonstrated significantly lower generalized seizures (20% vs. 70%m, P < 0.001) and frequency of fits per year (3 ±1 vs. 6 ±2, P < 0.001). No significant differences were observed regarding the diary of fits, possible cause (P = 0.638), age of onset (P = 0.953), and age of treatment (P = 0.953).
• Regarding KIDSCREEN-27 domains, the domains of the KIDSCREEN-27 did not significantly differ between the mono and polytherapy groups, including physical activities and health (P = 0.178), general mood and feelings (P = 1.0), family and free time (P = 0.731), friends (P = 0.241), school and learning (P = 0.139), and the total score (P = 0.672).
• Regarding the correlation between KIDSCREEN-27 total score and other parameters in the monotherapy group, in the monotherapy group, significant negative correlations were observed between the total score and age (r = -0.414, P = 0.003), weight (r = -0.405, P = 0.013), and height (r = -0.405, P = 0.004). No significant correlations were observed with other parameters, including birth weight (P = 0.594), hemoglobin level (P = 0.559), frequency of fits (P = 0.525), TLC (P = 0.711), neutrophils (P =0.9645), lymphocytes (P = 0.976), platelet count (P = 0.144), age of onset of fits (P = 0.423), and age of starting treatment (P = 0.423).
• Regarding the correlation between KIDSCREEN-27 total score and other parameters in the polytherapy group, in the polytherapy group, significant negative correlations were observed between the total score and age (r = -0.844, P < 0.001), weight (r = -0.813, P < 0.001), and height (r = -0.755, P < 0.001). No significant correlations were observed with other parameters, including birth weight (P = 0.139), hemoglobin level (P = 0.163), frequency of fits (P = 0.966), TLC (P = 0.170), neutrophils (P =0.239), lymphocytes (P = 0.172), platelet count (P = 0.702), age of onset of fits (P = 0.064), and age of starting treatment (P = 0.064).
• Regarding the total KIDSCREEN-27 score according to gender and type of seizures in the monotherapy group, the monotherapy group, the total score did not significantly differ according to gender (P = 0.950) and type of seizures (P = 0.677).
• Regarding the total KIDSCREEN-27 score according to gender and type of seizures in the polytherapy group, in the polytherapy group, the total score did not significantly differ according to gender (P = 0.316) and type of seizures (P = 0.795).
• In the monotherapy group, no significant correlations were observed between physical activities and health score and other parameters. In the polytherapy group, no significant correlations were observed between physical activities and health score and other parameters.
• In the monotherapy group, no significant differences were reported in the physical activities and health score according to gender (P = 0.925) and type of seizures (P = 0.255). In the polytherapy group, no significant differences were reported in the physical activities and health score according to gender (P = 0.182) and type of seizures (P = 0.854).
• In the monotherapy group, the general mood and feelings score showed a significant negative correlation with age (r = -0.361, P = 0.01), weight (r = -0.337, P = 0.017), and height (r = -290, P = 0.041). No significant correlations were observed with other parameters. In the polytherapy group, the general mood and feelings score showed a significant negative correlation with age (r = -0.846, P <0.001), weight (r = -0.811, P <0.001), height (r = -0.756, P <0.001), age of onset of fits (r = -0.297, P = 0.036), and age of starting treatment (r = -0.297, P = 0.036). No significant correlations were observed with other parameters.
• In the monotherapy group, no significant differences were reported in the general mood and feelings score according to gender (P = 0.825) and type of seizures (P = 0.374). In the polytherapy group, no significant differences were reported in the general mood and feelings score according to gender (P = 0.567) and type of seizures (P = 0.963).
• In the monotherapy group, the family and free time score showed significant negative correlations with age (r = -0.348, P = 0.013) and weight (r = -0.325, P = 0.021). No significant correlations were observed with other parameters. In the polytherapy group, the family and free time score showed significant negative correlations with age (r = -0.820, P <0.001), weight (r = -0.781, P <0.001), and height (r = -0.731, P <0.001). No significant correlations were observed with other parameters.
• In the monotherapy group, no significant differences were reported in the family and free time score according to gender (P = 0.798) and type of seizures (P = 0.344). In the polytherapy group, no significant differences were reported in the family and free time score according to gender (P = 0.422) and type of seizures (P = 0.961).
• In the monotherapy group, friends score showed significant negative correlations with age (r = -0.319, P = 0.024) and weight (r = -0.359, P = 0.01). No significant correlations were observed with other parameters. In the polytherapy group, friends score showed significant negative correlations with age (r = -0.741, P <0.001), weight (r = -0.712, P <0.001), and height (r = -0.659, P <0.001). No significant correlations were observed with other parameters.
• In the monotherapy group, no significant differences were reported in the friends score according to gender (P = 0.550) and type of seizures (P = 0.348). In the polytherapy group, no significant differences were reported in the friends score according to gender (P = 0.184) and type of seizures (P = 0.650).
• In the monotherapy group, school and learning score showed significant negative correlations with age (r = -0.392, P = 0.005), weight (r = -0.420, P = 0.002), and height (r = -0.360, P = 0.01). No significant correlations were observed with other parameters. In the polytherapy group, the school and learning score showed significant negative correlations with age (r = -0.728, P <0.001), weight (r = -0.716, P <0.001), and height (r = -0.679, P <0.001).
• In the monotherapy group, the school and learning score was significantly higher in those with focal seizures (11 ±3) than in those with generalized seizures (9 ±1). No significant difference was reported according to gender (P = 0.741). In the polytherapy group, no significant differences were reported in the school and learning score according to gender (P = 0.490) and type of seizures (P = 0.518).
• A multivariate linear regression analysis was done to predict KIDSCREEN-27 score. Age, gender, weight, height, type of therapy, and type of seizures were used as predictors. The model revealed that none of the above-mentioned factors was a significant predictor for KIDSCREEN-27 score.