Epilepsy and comorbidity

The aetiology of epilepsy has important implications for treatment.⁴ Multiple aetiologies may apply to an individual patient; they are not hierarchical, and the importance ascribed to a patient’s aetiological group may depend on their specific circumstances.⁴ Worldwide, epilepsy most commonly occurs as a direct result of an infection in which seizures are a core symptom of the disorder; it is important to note that ‘infectious aetiology’ refers to a person with epilepsy, not to a person with seizures occurring in the context of an acute infection such as meningitis.⁴

Many epilepsies are associated with comorbidities such as learning, psychological or behavioural problems, ranging in type and severity from subtle learning difficulties to intellectual disability, psychiatric disorders or psychosocial concerns.⁴ In more severe epilepsies, patients may suffer from a complex range of comorbidities including cerebral palsy, movement disorders, sleep and gastrointestinal disorders.⁴ Like aetiology, the presence of comorbidities should be considered at every stage of epilepsy treatment, to ensure appropriate management.⁴

References:

1.Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia 2014; 55 (4): 475–482.

2.Li J, Singh G, Keezer MR, Sander JW, on behalf of the SdHIELD Research Group. Thinking of epilepsy as a symptom. Lancet Neurol 2024; 23 (8): 770–771.

3.Yuen AWC, Keezer MR, Sander JW. Epilepsy is a neurological and a systemic disorder. Epilepsy Behav 2018; 78: 57–61.

4.Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia 2017; 58 (4): 512–521.