『醫方類聚ㆍ癲癎門』을 통해 본 한의학에서 癎疾의 역사

강연석(Yeon-Seok Kang),이상섭(Sang-Seop Lee),박희수(Hee-Sue Park),이서영(Seo-Young Lee) 한국의사학회 2011 한국의사학회지 Vol.24 No.1

『Classified Assemblage of Medical Prescriptions(醫方類聚) is a valuable material which can explain about historical records of East Asian medicine till 15th century. We can also konw what were regarded as important idea by contemporary doctors of Korean in ‘Chosun’ dynasty. And, Epilepsy is the one of the olddest diseases with a humankind history for a long time. All the concetps of disease including epilepsy in East Asia has been developed and specialized. So, we can find out some valuable facts from Epilepsy section Jin Classified Assemblage of Medical Prescriptions』. First, ‘Epilepsy’ was mixed with ‘Mad’, ‘Spasm’ before 7th century but after than, it had been divided into in detail. Since 14th century, we can find out that it was separated with ‘Spasm’ completely. In conclusion, ‘Epilepsy’ concept in 『Classified Assemblage of Medical Prescriptions』 at 15th century is similar with mordern ‘Epilepsy’ concept. Second, We can find out that ‘Epilepsy disease’ was divided into ‘Five epilepsy’ before 7th century, and divided into ‘external cause’, ‘internal cause’, ‘external & internal cause’ in 12th century. And, it also was divided into ‘yin’ or ‘yang’ epilepsy. So, ‘Epilepsy’ concept in 『Classified Assemblage of Medical Prescriptions』 at 15th century can be divided into ‘yin’ or ‘yang’ generally, and also it is similar with ‘Acute and slow shock’. Especially, ‘yinyang’ of epilepsy is related to organs & bouls, depth & shallow, interior & exterior, not cold & heat definitely. From now on, the researches about how it had been understood in East Asia can help to find out modern significance of Korean medicine. and, it would be helpful for comprehensive study about 『Classified Assemblage of Medical Prescriptions』 from these researches in each section.

The Economic Burden of Epilepsy in Korea, 2010

Jung, Jaehun,Seo, Hye-Young,Kim, Young Ae,Oh, In-Hwan,Lee, Yo Han,Yoon, Seok-Jun The Korean Society for Preventive Medicine 2013 Journal of Preventive Medicine and Public Health Vol.46 No.6

Objectives: The purposes of this study were to evaluate the prevalence of epilepsy and to estimate the cost of epilepsy in Korea, 2010. Methods: This study used a prevalence based approach to calculate the cost of epilepsy. Claims data from the Korean national health insurance and data from the Korea health panel, the Korea National Statistical Office's records of causes of death, and labor statistics were used to estimate the cost of epilepsy. Patients were defined as those who were hospitalized or visited an outpatient clinic during 2010 with a diagnosis of epilepsy (International Classification of Diseases 10th revision codes G40-G41). Total costs of epilepsy included direct medical costs, direct non-medical cost and indirect costs. Results: The annual prevalence of treated epilepsy was 228 per 100 000 population, and higher in men. The age-specific prevalence was highest for teenagers. The total economic burden of epilepsy was 536 billion Korean won (KW). Indirect cost (304 billion KW) was 1.3 times greater than direct cost (232 billion KW). By gender, the male (347 billion KW) were more burdened than the female (189 billion KW). The estimated cost in young age younger than 20 years old was 24.5% of the total burden of epilepsy. Conclusions: A significant portion of the economic burden of epilepsy is borne by people in young age. To reduce the economic burden of epilepsy, effective prevention and treatment strategies are needed.

Reduction of ipsilateral thalamic volume in temporal lobe epilepsy with hippocampal sclerosis

Park, Kang Min,Kim, Tae Hyung,Mun, Chi Woong,Shin, Kyong Jin,Ha, Sam Yeol,Park, JinSe,Lee, Byung In,Lee, Ho-Joon,Kim, Sung Eun CHURCHILL LIVINGSTONE 2018 JOURNAL OF CLINICAL NEUROSCIENCE Vol.55 No.-

<P><B>Abstract</B></P> <P>The thalamus plays an important role in the modulation of both focal and generalized seizures, but the mechanisms related to seizures may be different among epilepsy syndromes. The aim of this study is to investigate the thalamic atrophy in different epilepsy syndromes. We enrolled a total of 72 patients with epilepsy (22 patients with temporal lobe epilepsy with hippocampal sclerosis, 21 patients with extra-temporal lobe epilepsy, and 29 patients with juvenile myoclonic epilepsy). We analyzed structural volumes of the brain with FreeSurfer 5.1 software, and compared them among subgroups of epilepsy and normal control subjects. Moreover, we quantified correlations between the duration of epilepsy and the structural volumes with age and sex as covariates. The volumes of the ipsilateral hippocampus in temporal lobe epilepsy with hippocampal sclerosis were significantly smaller than those in extra-temporal lobe epilepsy and normal control subjects [analysis of variance (ANOVA), p < 0.001]. Although the volumes of the ipsilateral thalamus were not different from those of normal control subjects, the volumes of the ipsilateral thalamus were negatively correlated with duration of epilepsy in temporal lobe epilepsy with hippocampal sclerosis (r = −0.5, <I>p</I> = 0.02). However, the volumes of interest in extra-temporal lobe epilepsy and juvenile myoclonic epilepsy were not different from those in normal control subjects, and none of these structures were correlated with duration of epilepsy. These findings suggest that the role of the thalamus may be different in thalamo-limbic circuits among epilepsy syndromes.</P> <P><B>Highlights</B></P> <P> <UL> <LI> We investigate the thalamic atrophy in different epilepsy syndromes. </LI> <LI> There is a reduction of ipsilateral thalamic volume only in temporal lobe epilepsy with hippocampal sclerosis. </LI> <LI> The role of the thalamus is different in thalamo-limbic circuits among epilepsy syndromes. </LI> </UL> </P>

간질 환아에서 Handedness와 임상양상과의 관계

김부진(Pu Jin Kim),남상욱(Sang Ook Nam),박희주(Hee Ju Park) 대한소아신경학회 2001 대한소아신경학회지 Vol.9 No.1

목적: 오랜 기간동안 간질 환자에서 왼손잡이가 많다고 인식되어져 왔으나 이에 대한 연구는 흔하지 않다. 저자들은 간질 환아의 handedness를 조사하고 간질의 원인 및 뇌병변의 위치에 따른 왼손잡이의 빈도 및 handedness에 따른 여러 임상양상과의 관계를 분석하여 간질 환아에서 왼손잡이의 빈도와 왼손잡이의 주 기전이 간질 자체에 의한 것인지 간질과 동반된 뇌병변에 의한 것인지에 대한 연구로 간질의 원인, 치료 및 예후를 예측하는데 도움을 주고자 한다. 방법: 1996년 1월부터 1999년 8월까지 부산대학교병원 소아과에 경련으로 내원하여 간질로 진단받은 환아 158명을 대상으로 하였다. 대조군은 신경학적 결함이 없는 환아 158명이었다. 의무기록지에 의한 후향적 조사를 실시하여 두 군간의 handedness, 성별, 연령, 성별에 따른 handedness와 대조군에서 handedness에 다른 첫 경련 발생시의 연령, 연령분포, 간질의 가족력, 경련의 형태, 간질 원인의 유무, 증후성 간질의 원인, 해부학적 병변의 위치, 뇌파 결과에 의한 병변의 위치, 그리고 대상군을 특발성 간질 환아군과 증후성 간질 환아군으로 나누어 handedness를 조사하였다. 결과: 대상군과 대조군에서의 handedness, 성별, 연령, 성별에 따른 handedness의 차이는 없었다. 첫 경련시의 연령, 연령 분포, 경련의 형태, 가족력 유무와 handedness는 관계가 없었다. 증후성 간질 환아군은 오른손잡이에서 25명(17.9%)이었고 왼손잡이에서는 8명(44.0%)으로 왼손잡이에서 증후성 간질의 빈도가 높았고 증후성 간질 환아군에서 대조군에 비해 왼손잡이가 의미있게 많았으나 특발성 간질 환아군에서는 handedness의 차이가 없었다. 증후성 간질 환아군에서 좌뇌반구에 병변이 있는 경우, 뇌파검사상 왼손잡이에서 국소성 이상 소견있는 경우에 왼손잡이가 많았다. 결론: 대상군에서 대조군에 비해 왼손잡이의 빈도가 높지 않았으나 증후성 간질, 증후성 간질의 병변이 좌뇌반구에 있는 경우, 뇌파검사상 국소성 이상소견을 보인 경우에서 왼손잡이의 빈도가 높았다. 본 연구에서는 간질 환아에서의 왼손잡이의 높은 빈도는 증후성 간질의 원인으로 선행된 뇌병변에 주로 의한 것으로 생각된다. Purpose: Some reports left handedness is more common in epileptic patients compared with normal populations, but the study on this topics are rare. This can be due to epilepsy itself or brain lesion in epileptic patients. The study about the handedness in epileptic patients may help identifying the relationship of handedness and epilepsy, symptomatic epilepsy, sites of brain lesion, age at first seizure attack, family history of epilepsy. Methods: Subjects were 158 children with epilepsy who were admitted and able to describe the handedness at the Department of Pusan national university hospital between January 1996 and August 1999. We reviewed their sex, age, handedness. At patient group, age at first seizure, age distribution, family history of epilepsy, seizure type, etiology of epilepsy, causes of symptomatic epilepsy, site of brain lesion, localization by EEG were analyzed. Control group is 158 children without neurologic problem. We analysed handedness according to its variables. Results: There was no statistical significance in handedness between epileptic group and control group. There was no significant difference in handedness according to age at first seizure attack, seizure type, family history of epilepsy and age distribution. The left handedness is more common significantly in the group of symptomatic epilepsy, left side brain lesion and focal abnormality by EEG recording. Conclusion: We can find significant difference between symptomatic epileptic patient group, especially in the case of the left brain lesion and focal abnormality by EEG recording. In the case of bilateral or diffuse brain lesion, most of patients showed right handedness(87.5%). Accordingly, we concluded that high prevalence of left-handedness in children with epilepsy is more related with left side brain lesion than epilepsy itself. We assumed the social factors strongly affect the handedness of epileptic patients when we see that most of patients show the right handedness in the bilateral or diffuse brain lesions.

Pivotal Role of Subcortical Structures as a Network Hub in Focal Epilepsy: Evidence from Graph Theoretical Analysis Based on Diffusion-Tensor Imaging

박경민,이병인,신경진,하삼열,박진세,김시은,김성은 대한신경과학회 2019 Journal of Clinical Neurology Vol.15 No.1

Background and Purpose There is accumulating evidence that epilepsy is caused by network dysfunction. We evaluated the hub reorganization of subcortical structures in patients with focal epilepsy using graph theoretical analysis based on diffusion-tensor imaging (DTI). In addition, we investigated differences in the values of diffusion tensors and scalars, fractional anisotropy (FA), and mean diffusivity (MD) of subcortical structures between patients with focal epilepsy and healthy subjects. Methods One hundred patients with focal epilepsy and normal magnetic resonance imaging (MRI) findings and 80 age- and sex-matched healthy subjects were recruited prospectively. All subjects underwent DTI to obtain data suitable for graph theoretical analysis. We investigated the differences in the node strength, cluster coefficient, eigenvector centrality, page-rank centrality measures, FA, and MD of subcortical structures between patients with epilepsy and healthy subjects. Results After performing multiple corrections, the cluster coefficient and the eigenvector centrality of the globus pallidus were higher in patients with epilepsy than in healthy subjects (p=0.006 and p=0.008, respectively). In addition, the strength and the page-rank centrality of the globus pallidus tended to be higher in patients with epilepsy than in healthy subjects (p= 0.092 and p=0.032, respectively). The cluster coefficient of the putamen was lower in patients with epilepsy than in healthy subjects (p=0.004). The FA values of the caudate nucleus and thalamus were significantly lower in patients with epilepsy than in healthy subjects (p=0.009 and p=0.007, respectively), whereas the MD value of the thalamus was higher than that in healthy subjects (p=0.005). Conclusions We discovered the presence of hub reorganization of subcortical structures in focal epilepsy patients with normal MRI findings, suggesting that subcortical structures play a pivotal role as a hub in the epilepsy network. These findings further reinforce the idea that epilepsy is a network disease.

소아 간질 환자에서 장기적인 신장 변화의 추적 관찰

위주희,남상욱 대한소아청소년과학회 2008 Clinical and Experimental Pediatrics (CEP) Vol.51 No.10

Purpose:To assess the height growth of children with epilepsy receiving antiepileptic drugs (AEDs) and the related factors. Methods:The subjects were 148 children diagnosed with epilepsy at Pusan National University Hospital between January 1996 and December 2003, who received AEDs for more than 3 y. We measured height at the initiation of AED medication and at the last visit during AED medication. We analyzed the mean height standard deviation score (SDS) according to several factors, including sex, age at initial medication, seizure type, underlying causes of epilepsy, seizure frequency before AED medication, seizure control, number of AEDs, height SDS before medication, and duration of medication. Results:In the total population, height SDS at initial therapy and last follow-up were -0.06±1.39 versus 0.10±1.12 (P= 0.09). Children with controlled seizures showed a significant increase in height SDS, from -0.12±1.39 to 0.10±1.09 (P= 0.04), and children on medication for less than 6 y showed a significant increase in height SDS, from -0.09±1.54 to 0.21±1.07 (P=0.03). Also, children with negative initial height SDS showed a significant increase in height SDS (P<0.05). No height SDS changes were observed in any of the other groups, regardless of sex, seizure type, underlying causes of epilepsy, or age at initial medication. Conclusion:Neither epilepsy nor AED medication affects long-term height growth. Controlled seizure and short duration of AED medication are positive factors for height growth in children with epilepsy. (Korean J Pediatr 2008;51:1090-1095) Purpose:To assess the height growth of children with epilepsy receiving antiepileptic drugs (AEDs) and the related factors. Methods:The subjects were 148 children diagnosed with epilepsy at Pusan National University Hospital between January 1996 and December 2003, who received AEDs for more than 3 y. We measured height at the initiation of AED medication and at the last visit during AED medication. We analyzed the mean height standard deviation score (SDS) according to several factors, including sex, age at initial medication, seizure type, underlying causes of epilepsy, seizure frequency before AED medication, seizure control, number of AEDs, height SDS before medication, and duration of medication. Results:In the total population, height SDS at initial therapy and last follow-up were -0.06±1.39 versus 0.10±1.12 (P= 0.09). Children with controlled seizures showed a significant increase in height SDS, from -0.12±1.39 to 0.10±1.09 (P= 0.04), and children on medication for less than 6 y showed a significant increase in height SDS, from -0.09±1.54 to 0.21±1.07 (P=0.03). Also, children with negative initial height SDS showed a significant increase in height SDS (P<0.05). No height SDS changes were observed in any of the other groups, regardless of sex, seizure type, underlying causes of epilepsy, or age at initial medication. Conclusion:Neither epilepsy nor AED medication affects long-term height growth. Controlled seizure and short duration of AED medication are positive factors for height growth in children with epilepsy. (Korean J Pediatr 2008;51:1090-1095)

Characteristics of Epilepsy in Children with Cerebral Palsy: A Single Tertiary Center Study

Hyein Yeo,한지윤,Jee Min Kim 대한소아신경학회 2023 대한소아신경학회지 Vol.31 No.4

Purpose: The aim of this study was to describe the characteristics of epilepsy in cerebral palsy (CP) patients and identify risk factors for epilepsy and drug-resistant epilepsy. Methods: CP patients aged 18 years old or younger who visited the pediatric neurology department and/or rehabilitation department of a tertiary care hospital between January 2016 and December 2022 with a minimum follow-up period of 2 years were included. Demographic and clinical data, seizure characteristics, brain imaging, electroencephalography, and genetic evaluation results were reviewed retrospectively. Results: Among 268 patients included in this study, 36.9% had epilepsy and 10.8% had drug-resistant epilepsy. Asphyxia (29.3%), hemorrhage, infarction, and brain infection (25.3%) were associated with epilepsy. Epileptic CP patients were more likely to experience neonatal seizures (18.2% vs. 4.1%, P<0.001) and febrile seizures (12.1% vs. 7.1%, P=0.02) than non-epilepsy CP patients. The most common cerebral subtype in patients with epilepsy was spastic quadriplegia (59.6%). Epilepsy patients were more severely impaired in gross motor function, with worse intellectual disability. Patients with macrocephaly or cerebral malformation were more likely to have drug resistance. Valproate (51.7% and 25.7%) and levetiracetam (41.4% and 25.7%) were the two most commonly used antiseizure medications, both in monotherapy and polytherapy. Conclusion: A history of asphyxia, febrile seizure, neonatal seizure, spastic quadriplegia, more severely impaired gross motor function, and intellectual disability were found to be risk factors for epilepsy. Further research with prospective data collection to develop a model for predicting seizures or epilepsy in CP patients is needed.

주의력결핍 과잉행동장애(Attention Deficit Hyperactive Disorder:ADHD) 환아의 뇌전증 유무에 따른 임상 양상

심지윤(Gi Youn Sim),손정우(Jung-Woo Son),김원섭(Won Seop Kim) 대한소아신경학회 2012 대한소아신경학회지 Vol.20 No.3

목 적 : 최근의 연구에 따르면 ADHD를 가진 환아들 중 31-40%가 Epilepsy를 가지고 있다. 하지만 국내에서 ADHD를 가진 환아에서 뇌전증 유무에 따른 임상 연구가 부족하다. 방 법 : 이 연구는 2005년 1월부터 2010년 6월까지 청주 성모 병원 소아 정신과에 내원한 ADHD 환아 38명과 같은 기간에 충북대학교 병원 소아 정신과와 소아 청소년과를 내원한 ADHD와 뇌전증을 가진 환아 34명을 대상으로 후향적으로 의무기록을 분석하였다. 결 과 : 1) ADHD와 뇌전증이 같이 있는 환아의 경련의 형태는 단순 부분 발작은 9례, 복잡 부분 발작은 3례, 전신 강직간대 발작은 3례, 전신 강직 발작은 5례, 탈력 발작은 1례, 결신 발작은 2례, 그 외의 발작은 11례 이었다. 2) ADHD와 뇌전증이 같이 있는 환아의 뇌파상 간질파의 부위는 전두엽이 15례(44.1%)였다. 3) ADHD 와 뇌전증이 같이 있는 환 아의 12개월 동안 경련이 50% 이상 감소한 경우는 76.4% 이었으며, 경련의 100% 감소한 경우는 52.9% 였다. 4) ADHD와 뇌전증이 같이 있는 환아의 뇌 자기공명영상 소견은 비 종양적 뇌하수체 낭종, multifocal harmatous lesion, 뇌 위축, 맥락막 틈새 낭, 측 뇌실의 좌측 측 두각의 확장, 결절성 경화증, 안쪽 측두 경화였다. 5) ADHD의 형태는 ADHD와 뇌전증이 같이 있는 환아에서는 복합형이 76.4%였으며 ADHD만 있는 환아에서는 주의력 결핍 형이 50.5%였다( P=0.004). 6)ADHD와 뇌전증이 같이 있는 환아가 ADHD만 있는 환아에 비해서 학습장애를 더 보였다( P=0.01). 7)ADHD 약물 치료에 대한 반응은 ADHD와 뇌전증이 같이 있는 환아에서는 74%에서 반응이 있는 것으로 나타났으며 ADHD만 있는 환아에서는 60.5%에서 반응이 있는 것으로 나타났다. 8)부작용은 ADHD와 뇌전증이 있는 환아는 발작 증가가 1례, 수면 장애가 1례 였으며, ADHD만 있는 환아는 수면 장애가 4례, 오심이 1례, 식욕 감퇴가 1례였다. 결 론 : 본 연구는 ADHD 환아의 뇌전증 유무에 따른 임상 연구로 뇌전증이 있는 경우는 ADHD 약물 치료에 대한 반응 및 임상경과와 정도가 다른 것으로 생각되며 향후 대규모 연구가 필요할 것으로 사료된다. Purpose : Attention Deficit Hyperactivity Disorder (ADHD) is known to be more common in children with epilepsy than in the general population. Thirty one to forty percent of ADHD is accompanied with epilepsy. Few studies regarding this matter have been reported in Korea. This study was aimed to evaluate the comorbidity of ADHD in children with epilepsy. Methods : This is a two center based, retrospective and controlled study. Thirty four ADHD children with epilepsy from Chungbuk National University hospital and 38 ADHD children without epilepsy from Cheonju St. Mary's hospital were recruited from January 2005 to June 2010. Results : In ADHD children with epilepsy, twelve (35.2%) had partial seizures, 11 (32.2%) did generalized seizures and 11 (32.2%) were unclassified. EEG abnormalities were found in the frontal lobe (15 cases), in the central lobe (7 cases), in the temporal lobe (6 cases), and in the occipital lobe (3 cases). In ADHD children with epilepsy, the combined type was major (76.4%) and in ADHD children without epilepsy, the inattentive type was major (50.5%) (P=0.004). Learning disability was mor common in ADHD with epilepsy than in ADHD without epilepsy (P=0.01). Conclusion : This study showed that ADHD children with epilepsy are more likely to have combined type (76.4%) and learning disability as compared with ADHD without epilepsy.

난치간질 환자의 해마용적 측정을 통한 해마 위축 확인

강승호,김병채,남태승,김준태,최성민,이승한,박만석,김명규,조기현 대한신경과학회 2011 대한신경과학회지 Vol.29 No.3

Background: Recurrent seizures result in brain damage, but it is usually gradual, minimal, and difficult to observe by visual inspection of magnetic resonance images (MRIs). It is well known that hippocampal structure is vulnerable to seizure-associated brain damage. We measured the hippocampal volume in patients with epilepsy to evaluate the degree of damage to the hippocampus. Methods: We recruited 33 patients with epilepsy and 21 healthy subjects from January 2007 to December 2008. We subclassified the patients into two groups: (1) 14 patients with intractable epilepsy and (2) 19 patients with drug-responsive epilepsy. In each group, the volumes of the left and right hippocampus were measured by manual drawing on brain MRIs. We compared the hippocampal volume in intractable epilepsy, drug-responsive epilepsy, and healthy subjects. The compounding effect of hippocampal sclerosis was ruled out by excluding eight patients with hippocampal sclerosis; we then compared the hippocampal volume in the two groups with epilepsy. Results: The volume of the bilateral hippocampus on brain MRIs was smaller in patients with intractable epilepsy than in those with drug-responsive epilepsy and healthy subjects (left, p<0.004; right, p<0.03). After excluding the patients with hippocampal sclerosis by visual inspection, the hippocampal volumes were also found to be smaller in patients with intractable epilepsy than in those with drug-responsive epilepsy (left, p<0.04; right, p<0.05). Conclusions: While there is no definitive abnormality of the hippocampus on visual inspection of brain MRIs, we determined the degree of hippocampal atrophy and volume loss in patients with intractable epilepsy. Hippocampal volumetry will be helpful for the assessment of brain damage in patients with intractable epilepsy. Background: Recurrent seizures result in brain damage, but it is usually gradual, minimal, and difficult to observe by visual inspection of magnetic resonance images (MRIs). It is well known that hippocampal structure is vulnerable to seizure-associated brain damage. We measured the hippocampal volume in patients with epilepsy to evaluate the degree of damage to the hippocampus. Methods: We recruited 33 patients with epilepsy and 21 healthy subjects from January 2007 to December 2008. We subclassified the patients into two groups: (1) 14 patients with intractable epilepsy and (2) 19 patients with drug-responsive epilepsy. In each group, the volumes of the left and right hippocampus were measured by manual drawing on brain MRIs. We compared the hippocampal volume in intractable epilepsy, drug-responsive epilepsy, and healthy subjects. The compounding effect of hippocampal sclerosis was ruled out by excluding eight patients with hippocampal sclerosis; we then compared the hippocampal volume in the two groups with epilepsy. Results: The volume of the bilateral hippocampus on brain MRIs was smaller in patients with intractable epilepsy than in those with drug-responsive epilepsy and healthy subjects (left, p<0.004; right, p<0.03). After excluding the patients with hippocampal sclerosis by visual inspection, the hippocampal volumes were also found to be smaller in patients with intractable epilepsy than in those with drug-responsive epilepsy (left, p<0.04; right, p<0.05). Conclusions: While there is no definitive abnormality of the hippocampus on visual inspection of brain MRIs, we determined the degree of hippocampal atrophy and volume loss in patients with intractable epilepsy. Hippocampal volumetry will be helpful for the assessment of brain damage in patients with intractable epilepsy.

Zonisamide 혹은 Topiramate를 사용한 뇌전증 환자에서 항뇌전증제 투약 전후 삶의 질 비교

홍형기,김지언,이장준,이세진,박성파,이상도 대한신경과학회 2011 대한신경과학회지 Vol.29 No.3

Background: Patients with epilepsy experience impairments in their quality of life (QOL). The objective of this study was to determine the influences of clinical factors on QOL and to compare QOL before and after antiepileptic drug (AED) treatment. Methods: A cohort of 79 patients with epilepsy (43 male and 36 female) was recruited for this prospective study. The Quality of Life in Epilepsy (QOLIE)-31 survey was applied to evaluate QOL. The QOLIE-31 questionnaire was completed by the subjects before and 24 weeks after AED monotherapy (zonisamide or topiramate). The relationships of demographic, social, and clinical factors with QOL were evaluated. Results: There was a negative correlation between seizure frequency and QOL in patients with epilepsy (p<0.05). The scores of patients without adverse effect were significantly higher for the seizure worry item of the QOLIE-31 questionnaire at 24 weeks compared to baseline (p<0.05). No other significant differences were found for any of the other QOLIE-31 items. Conclusions: Age, sex, seizure frequency, AED treatment, and AED adverse effects were significant clinical factors affecting QOL in patients with epilepsy. It is suggested that the physician should recognize these factors and manage them appropriately to improve the QOL of patients with epilepsy. Background: Patients with epilepsy experience impairments in their quality of life (QOL). The objective of this study was to determine the influences of clinical factors on QOL and to compare QOL before and after antiepileptic drug (AED) treatment. Methods: A cohort of 79 patients with epilepsy (43 male and 36 female) was recruited for this prospective study. The Quality of Life in Epilepsy (QOLIE)-31 survey was applied to evaluate QOL. The QOLIE-31 questionnaire was completed by the subjects before and 24 weeks after AED monotherapy (zonisamide or topiramate). The relationships of demographic, social, and clinical factors with QOL were evaluated. Results: There was a negative correlation between seizure frequency and QOL in patients with epilepsy (p<0.05). The scores of patients without adverse effect were significantly higher for the seizure worry item of the QOLIE-31 questionnaire at 24 weeks compared to baseline (p<0.05). No other significant differences were found for any of the other QOLIE-31 items. Conclusions: Age, sex, seizure frequency, AED treatment, and AED adverse effects were significant clinical factors affecting QOL in patients with epilepsy. It is suggested that the physician should recognize these factors and manage them appropriately to improve the QOL of patients with epilepsy.