Clinical characteristics and quality of life with Dravet syndrome: results of the German cohort of the Dravet syndrome caregiver survey (DISCUSS)

Abstract

Background: Dravet syndrome (DS) is a rare treatment-resistant epilepsy syndrome with onset in infancy. It is associated with high morbidity and mortality. Objective: The aims of the cross-sectional Dravet syndrome caregiver survey (DISCUSS) are to identify and describe those factors that may have an impact on the disease burden of patients with DS and their caregivers. The data of the German cohort are presented. Material and methods: The data collection was based on an anonymous survey of parents, which was statistically analyzed for the different age groups. Results: The questionnaire was completed by 68 caregivers of DS patients with a mean age of 10 years (median 9 years, range 1–26 years). In the previous 3 months only 3 patients (4.4%) were seizure-free and 97% of the patients older than 5 years (n = 45) had at least 1 comorbidity. The antiepileptic drugs most commonly used at the time of the survey were valproate, potassium bromide, stiripentol, clobazam and topiramate. Sodium channel blockers, phenobarbital and levetiracetam have been used in past, but were given less frequently at the time of the survey. The patients’ quality of life was lower than that of the general population. The disease of a family member with DS has a major impact on parents and siblings. Conclusion: Despite individual combination therapies, most patients with DS are not seizure-free. Overall, the use of less effective drugs and of the contraindicated sodium channel blockers decreased and has shifted in favor of more effective drugs. New treatment and care concepts are needed to improve the care of patients with DS and to relieve the burden on parents and siblings.