Novel questionnaire reliably assesses antiepileptic adverse effects in children

By Liam Davenport, medwireNews Reporter

The adverse effects of antiepileptic drugs (AEDs) can be reliably measured in children from across the epilepsy spectrum in clinical and research settings with the novel Pediatric Epilepsy Side Effects Questionnaire (PESQ), say US scientists.

"Assessment of side effects is challenging due to the use of different descriptive terms and the difficulty in determining their severity in an objective way," explain Diego Morita and colleagues from Cincinnati Children's Hospital Medical Center in Ohio. "The PESQ addresses many of these issues: it standardizes terminology, provides an objective measurement, and quantifies side effects that can be followed longitudinally."

Sanjeev Kothare, from Children's Hospital Boston, Massachusetts, and Janelle Wagner, from Medical University of South Carolina, Charleston, suggest in an accompanying editorial in Neurology: "Use of the PESQ in new-onset or established epilepsy and also in well-controlled as well as refractory seizures may... inform future clinical decisions and provide data to formulate recommendations for AED use, ultimately improving adherence and quality of life in youth with epilepsy."

Noting the limitations of current adverse effect measures, such as the Hague Side Effect Scale, in assessing pediatric epilepsy, the researchers initially developed a 44-item questionnaire using simplified language and administered it to caregivers of children with new onset or chronic epilepsy.

Using 495 responses, the team identified a five-factor solution that yielded a final instrument - the PESQ - with 19 items and five subscales: cognitive, motor, behavioral, general neurologic, and weight adverse effects.

The questionnaire accounted for 99% of the variance. Internal consistency coefficients ranged from 0.72 to 0.93, while test-retest reliabilities ranged from 0.73 to 0.97.

The number of adverse effects increased as the number of drugs increased, with all five subscale scores significantly affected, thus demonstrating PESQ construct validity, the team notes.

The researchers also found that children receiving valproic acid had significantly higher weight scores than those given carbamazepine.

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