The intricate relationship between epilepsy and cognitive, psychiatric, and social problems is explored in a new paper published as part of The Lancet Series on epilepsy.
Children and adults with epilepsy show an increased prevalence of psychiatric disorders (mood disorders, anxiety disorders, attention deficit hyperactive disorder (ADHD)), cognitive disorders (memory, language, problem solving) and social problems (unemployment, problematic social interactions), but the relationships between epilepsy and these complications that often occur alongside it are complex, and poorly understood.
The psychiatric, cognitive and social problems that often occur in conjunction with childhood and adult epilepsies are referred to by doctors as 'comorbidities', meaning that they have a greater than coincidence chance of appearing alongside each other, but there is not necessarily a causal relationship between them.
The authors point to a number of possible factors responsible for these comorbidities, including characteristics of the epilepsy and its medication treatment, underlying brain disorder, and epilepsy related disruptions of normal neurodevelopment and ageing.
According to one of the paper's authors, Dr Bruce Hermann, of the University of Wisconsin-Madison, USA, "Screening for psychiatric, cognitive and social comorbidities is essential not only in established but also newly diagnosed epilepsy as well as before beginning any new drug treatment. Early identification and treatment of these comorbidities would enhance both quality of care as well as the quality of life of affected children and adults."
Dr Hermann concludes that "Major advances have begun to uncover the potential mediators of lifespan psychiatric, cognitive, and social comorbidities in epilepsy, but gaps remain in the early detection, treatment, and prevention of these disorders."
Contact: Dr Bruce Hermann, University of Wisconsin-Madison, USA
E) hermann@neurology.wisc.edu
Journal
The Lancet