Routine screening for psychiatric, cognitive and social problems could enhance the quality of care and quality of life for children and adults with epilepsy, according to a study by UC Irvine neurologist Dr. Jack Lin and colleagues at the University of Wisconsin-Madison and Amedeo Avogadro University in Italy.
Physicians who treat those with epilepsy often focus on seizures, Lin said. However, patients show an increased prevalence of psychiatric issues (mood, anxiety or attention-deficit/hyperactivity disorders), cognitive disorders (in memory, language or problem solving) and social difficulties (involving employment or personal interactions). The relationship between epilepsy and these complications is complex and poorly understood. Lin said they may present greater problems for a patient if left untreated.
"Screening for psychiatric, cognitive and social comorbidities is essential not only in established cases but also with newly diagnosed epilepsy," Lin said. "By doing so, we can ensure that these issues are treated and that patients have a better quality of life."
He emphasized that screening should also be conducted prior to any new drug treatment.
Problems that occur in conjunction with childhood and adult epilepsy are referred to by doctors as comorbidities, meaning that they have a greater than coincidental chance of appearing alongside each other though there is not necessarily a causal relationship between them.
The study suggests a number of possible factors responsible for these comorbidities, including the characteristics of epilepsy and its medication protocol, underlying brain disorders, and epilepsy-related disruptions of normal neurodevelopment and aging.
While experts have begun to recognize the effects of psychiatric, cognitive and social comorbidities in epilepsy, Lin noted, gaps remain in the early detection, treatment and prevention of these issues.
- Jack J Lin, Marco Mula, Bruce P Hermann. Uncovering the neurobehavioural comorbidities of epilepsy over the lifespan. The Lancet, 2012; 380 (9848): 1180 DOI: 10.1016/S0140-6736(12)61455-X
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