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Epilepsy / Treatment

Epilepsy care must improve

Children and adults with epilepsy should be offered routine screening for psychiatric, cognitive, and social comorbidities to enhance the quality of their care and their quality of life.

Writing today in a new paper published as part of a series of features in The Lancet on epilepsy, Dr Bruce Hermann, of the University of Wisconsin-Madison, USA, says children and adults with epilepsy show an increased prevalence of mood disorders, anxiety disorders, attention deficit hyperactive disorder, cognitive disorders, (memory, language, problem solving) and social problems (unemployment, problematic social interactions).

But he says the relationships between epilepsy and these complications that often occur alongside it are complex, and poorly understood.

“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 adds: “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.”

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.

Source: Mark Gould www. onmedica.com

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