OBJECTIVE The objective of this study was to explore the prevalence and predictors of limitations causing disability in patients treated for seizures or epilepsy compared with patients without epilepsy. METHODS This was a retrospective cross-sectional study using the National Health and Nutrition Examination Survey (NHANES). We included all participants ≥20 years old for 2013-2018. We classified patients as having epilepsy if they reported taking at least one prescription medication to treat seizures or epilepsy. Physical, mental, and social limitations were determined from interview questions. We report the prevalence of any limitation and total number of limitations for participants without vs. with epilepsy using serial negative binomial regressions and severity of individual limitations according to epilepsy status. RESULTS We included 17,057 participants, of whom 148 (0.8%) had epilepsy. Overall, 80% (95% confidence interval [CI]: 73%-86%) with epilepsy vs. 38% (95% CI: 36%-39%) without epilepsy reported at least 1 limitation (p < 0.01). The mean number of limitations was 7.5 (95% CI: 6.2-8.8) for those with epilepsy vs. 2.4 (95% CI: 2.3-2.6) for those without epilepsy (p < 0.01). Epilepsy was associated with an incidence rate ratio (IRR) of 3.1 (95% CI: 2.6-3.7) in an unadjusted negative binomial regression. After adjusting for demographics and comorbidities, this association was no longer significant (IRR: 1.2, 95% CI: 0.9-1.7). Limitations cited by 40-50% of participants with epilepsy included stooping/kneeling/crouching, standing for long periods of time, and pushing/pulling objects. Limitation severity was consistently higher in patients with epilepsy. CONCLUSIONS Patients with epilepsy had 3.1 times as many physical, mental, or social limitations compared with those without epilepsy, and disability severity was consistently higher. This effect was attenuated after considering baseline variables such as smoking and depression severity. Our work implies the importance of structured mental health screening and self-management programs targeting mood, weight, and lifestyle as potential leverage points towards alleviating epilepsy-related disability.

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癫痫患者的残疾：一项具有全国代表性的横断面研究

目的 本研究的目的是探讨与非癫痫患者相比，接受癫痫或癫痫治疗的患者中导致残疾的局限性的发生率和预测因素。方法 这是一项使用全国健康和营养检查调查 (NHANES) 进行的回顾性横断面研究。我们纳入了 2013-2018 年所有 20 岁以上的参与者。如果患者报告至少服用一种处方药来治疗癫痫发作或癫痫，我们将其归类为癫痫患者。身体、精神和社会限制由面试问题确定。我们使用连续负二项式回归和根据癫痫状态的个体限制的严重程度报告了没有与患有癫痫的参与者的任何限制的普遍性和限制的总数。结果 我们纳入了 17，057 名参与者，其中 148 人 (0.8%) 患有癫痫症。总体而言，80%（95% 置信区间 [CI]：73%-86%）有癫痫与 38%（95% CI：36%-39%）没有癫痫报告至少有 1 项限制（p < 0.01）。癫痫患者的平均限制次数为 7.5（95% CI：6.2-8.8），而无癫痫患者为 2.4（95% CI：2.3-2.6）（p < 0.01）。在未经调整的负二项式回归中，癫痫与发病率比 (IRR) 为 3.1（95% CI：2.6-3.7）相关。在调整人口统计学和合并症后，这种关联不再显着（IRR：1.2，95% CI：0.9-1.7）。40-50% 的癫痫参与者提到的限制包括弯腰/跪下/蹲下、长时间站立和推/拉物体。癫痫患者的局限性严重程度始终较高。结论与非癫痫患者相比，癫痫患者的身体、精神或社会限制是其 3.1 倍，并且残疾严重程度始终较高。在考虑了吸烟和抑郁严重程度等基线变量后，这种影响减弱了。我们的工作意味着针对情绪、体重和生活方式的结构化心理健康筛查和自我管理计划的重要性，因为潜在的杠杆指向减轻癫痫相关的残疾。