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Association of epilepsy and comorbid conditions

    Michael Seidenberg

    † Author for correspondence

    Rosalind Franklin University of Medicine & Science, Department of Psychology, 3333 Green Bay Road, North Chicago, IL 60064, USA.

    ,
    Dalin T Pulsipher

    Rosalind Franklin University of Medicine & Science, Department of Psychology, 3333 Green Bay Road, North Chicago, IL 60064, USA.

    &
    Bruce Hermann

    University of Wisconsin Hospital, Department of Neurology, 600 Highland Avenue, Madison, WI 53792, USA.

    Published Online:https://doi.org/10.2217/fnl.09.32

    Comorbid health conditions are common among people with epilepsy. Proposed explanations for this association include the possibility that first, epilepsy (including its treatment) causes the comorbid condition; second, the comorbid condition (including its treatment) causes epilepsy; or third, a common pathogenic mechanism mediates the co-occurrence of epilepsy and the comorbid condition. It is unlikely that a single explanation will suffice for all of the epilepsy comorbid conditions. Determining the basis of the association between epilepsy and its comorbid conditions has important implications for diagnosis and management. In this paper, we discuss this issue in the context of five common epilepsy comorbid conditions: bone health and fractures, stroke, depression, migraine and attention-deficit hyperactivity disorder. Current findings, research limitations and future directions of research efforts are discussed.

    Papers of special note have been highlighted as: ▪ of interest ▪▪ of considerable interest

    Bibliography

    • Gaitatzis A, Carroll K, Majeed A, Sander WJ: The epidemiology of the comorbidity of epilepsy in the general population. Epilepsia45,1613–1622 (2004).▪ Only identified epidemiological study to use a medical database to identify comorbidities using a large sample size.
    • Tellez-Zenteno JF, Matijevic S, Wiebe S: Somatic comorbidity of epilepsy in the general population in Canada. Epilepsia46,1955–1962 (2005).
    • Bazil CW: Comprehensive care of the epilepsy patient – control, comorbidity, and cost. Epilepsia45,3–12 (2004).
    • Pulsipher DT, Seidenberg M, Jones J, Hermann B: Quality of life and comorbid medical and psychiatric conditions in temporal lobe epilepsy. Epilepsy Behav.9,510–514 (2006).
    • Wiebe S, Hesdorffer DC: Epilepsy: being ill in more ways than one. Epilepsy Curr.7,145–148 (2007).
    • Boro A, Haut S: Medical comorbidities in the treatment of epilepsy. Epilepsy Behav.4,S2–S12 (2003).
    • Forsgren L: Prevalence of epilepsy in adults in northern Sweden. Epilepsia33,450–458 (1992).
    • Gaitatzis A, Trimble MR, Sander JW: The psychiatric comorbidity of epilepsy. Acta Neurol. Scand.110,207–220 (2004).
    • Jalava M, Sillanpaa M: Concurrent illnesses in adults with childhood-onset epilepsy: a population-based 35-year follow-up study. Epilepsia37,1155–1163 (1996).
    • 10  Kobau R, Zahran H, Thurman DJ et al.: Epilepsy surveillance among adults – 19 states, behavioral risk factor surveillance system. MMWR Surveill. Summ.57(6),1–20 (2008).
    • 11  Strine TW, Kobau R, Chapman DP et al.: Psychological distress, comorbidities, and health behaviors among U.S. adults with seizures: results from the 2002 National Health Interview Survey. Epilepsia46,1133–1139 (2005).
    • 12  Davies S, Heyman I, Goodman R: A population survey of mental health problems in children with epilepsy. Dev. Med. Child Neurol.45,292–295 (2003).
    • 13  Kobau R, Gilliam F, Thurman DJ: Prevalence of self-reported epilepsy or seizure disorder and its associations with self-reported depression and anxiety: results from the 2004 Healthstyles Survey. Epilepsia47,1915–1921 (2006).
    • 14  Tellez-Zenteno JF, Patten SB, Jette N, Williams J, Wiebe S: Psychiatric comorbidity in epilepsy: a population-based analysis. Epilepsia48,2336–2344 (2007).
    • 15  van Blarikom W, Tan IY, Aldenkamp AP, van Gennep ATG: Epilepsy, intellectual disability, and living environment: a critical review. Epilepsy Behav.9,14–18 (2006).
    • 16  Jetter GM, Cavazos JE: Epilepsy in the elderly. Semin. Neurol.28,336–341 (2008).
    • 17  Souverein PC, Webb DJ, Weil JG, Van Staa TP, Egberts ACG: Use of antiepileptic drugs and risk of fractures: case–control study among patients with epilepsy. Neurology66,1318–1324 (2006).
    • 18  Vestergaard P: Epilepsy, osteoporosis and fracture risk – a meta-analysis. Acta Neurol. Scand.112,277–286 (2005).▪ Detailed meta-analytic study examining bone health problems in epilepsy and discussion of possible mechanisms.
    • 19  Lado F, Spiegel R, Masur JH, Boro A, Haut SR: Value of routine screening for bone demineralization in an urban population of patients with epilepsy. Epilepsy Res.78,155–160 (2008).
    • 20  Elliott JO, Lu B, Moore JL, McAuley JW, Long L: Exercise, diet, health behaviors, and risk factors among persons with epilepsy based on the California Health Interview Survey, 2005. Epilepsy Behav.13,307–315 (2008).
    • 21  Rowan AJ: Common morbidities influence development, treatment strategies, and expected outcomes. Geriatrics60,30–34 (2005).
    • 22  Bladin CF, Alexandrov AV, Bellavance A et al.: Seizures after stroke: a prospective multicenter study. Arch. Neurol.57,1617–1622 (2000).
    • 23  So EL, Annegers JF, Hauser WA, O’Brien PC, Whisnant JP: Population-based study of seizure disorders after cerebral infarction. Neurology46,350–355 (1996).
    • 24  Kotila M, Waltimo O: Epilepsy after stroke. Epilepsia33,495–498 (1992).
    • 25  Cordonnier C, Henon H, Derambure P, Pasquier F, Leys D: Influence of pre-existing dementia on the risk of post-stroke epileptic seizures. J. Neurol. Neurosurg. Psychiatry76,1649–1653 (2005).
    • 26  LaFrance WC, Kanner AM, Hermann B: Psychiatric comorbidities in epilepsy. Int. Rev. Neurobiol.83,347–383 (2008).▪▪ Extensive and comprehensive review of all psychiatric comorbidities in epilepsy.
    • 27  Schmitz B: Depression and mania in patients with epilepsy. Epilepsia46,45–49 (2005).
    • 28  Hermann BP, Seidenberg M, Haltiner A, Wyler AR: Mood state in unilateral temporal lobe epilepsy. Biol. Psychiatry30,1205–1218 (1991).
    • 29  Austin JK, Caplan R: Behavioral and psychiatric comorbidities in pediatric epilepsy: toward an integrative model. Epilepsia48,1639–1651 (2007).▪▪ Comprehensive review of psychological factors and proposal of an integrative model that combines biological factors.
    • 30  Hesdorffer DC, Hauser WA, Annegers JF, Cascino G: Major depression is a risk factor for seizures in older adults. Ann. Neurol.47,246–249 (2000).
    • 31  Ekinci O, Titus JB, Rodopman AA, Berkem M, Trevathan E: Depression and anxiety in children and adolescents with epilepsy: prevalence, risk factors, and treatment. Epilepsy Behav.14,8–18 (2009).
    • 32  Jones JE, Watson R, Sheth R et al.: Psychiatric comorbidity in children with new onset epilepsy. Dev. Med. Child Neurol.49,493–497 (2007).
    • 33  Kanner AM: Depression in epilepsy: prevalence, clinical semiology, pathogenic mechanisms, and treatment. Biol. Psychiatry54,388–398 (2003).▪▪ Detailed review of presentation of depression in epilepsy, risk factors and mechanisms.
    • 34  Kanner AM: Epilepsy and mood disorders. Epilepsia48,20–22 (2007).
    • 35  Rosche J, Uhlmann C, Froscher W: Low serum folate levels as a risk factor for depressive mood in patients with chronic epilepsy. J. Neuropsychiatry Clin. Neurosci.15,64–66 (2003).
    • 36  Ludvigsson P, Hesdorffer D, Olafsson E, Kjartansson O, Hauser WA: Migraine with aura is a risk factor for unprovoked seizures in children. Ann. Neurol.59,210–213 (2006).
    • 37  Bigal ME, Lipton RB, Cohen J, Silberstein SD: Epilepsy and migraine. Epilepsy Behav.4(Suppl. 2),S13–S24 (2003).
    • 38  Scher AI, Bigal ME, Lipton RB: Comorbidity of migraine. Curr. Opin. Neurol.18,305–310 (2005).
    • 39  Calabresi P, Galletti F, Rossi C, Sarchielli P, Cupini LM: Antiepileptic drugs in migraine: from clinical aspects to cellular mechanisms. Trends Pharmacol. Sci.28,188–195 (2007).
    • 40  Gorji A: Spreading depression: a review of the clinical relevance. Brain Res. Brain Res. Rev.38,33–60 (2001).▪▪ Most extensive review of cortical spreading depression in migraine to date.
    • 41  Rogawski MA: Common pathophysiologic mechanisms in migraine and epilepsy. Arch. Neurol.65,709–714 (2008).
    • 42  Gargus JJ: Genetic calcium signaling abnormalities in the central nervous system: seizures, migraine, and autism. Ann. NY Acad. Sci.1151,133–156 (2009).
    • 43  Crompton DE, Berkovic SF: The borderland of epilepsy: clinical and molecular features of phenomena that mimic epileptic seizures. Lancet Neurol.8,370–381 (2009).
    • 44  Ounsted C: The hyperkinetic syndrome in epileptic children. Lancet269,303–311 (1955).
    • 45  Elliott JO, Lu B, Shneker B, Charyton C, Moore JL: Comorbidity, health screening, and quality of life among persons with a history of epilepsy. Epilepsy Behav.14,125–129 (2009).
    • 46  Hesdorffer DC, Ludvigsson P, Olafsson E, Gudmundsson G, Kjartansson O, Hauser WA: ADHD as a risk factor for incident unprovoked seizures and epilepsy in children. Arch. Gen. Psychiatry61,731–736 (2004).
    • 47  Dunn DW, Austin JK, Harezlak J, Ambrosius WT: ADHD and epilepsy in childhood. Dev. Med. Child Neurol.45,50–54 (2003).
    • 48  Hermann B, Jones J, Dabbs K et al.: The frequency, complications and aetiology of ADHD in new onset paediatric epilepsy. Brain130,3135–3148 (2007).
    • 49  Sherman EM, Slick DJ, Connolly MB, Eyrl KL: ADHD, neurological correlates and health-related quality of life in severe pediatric epilepsy. Epilepsia48,1083–1091 (2007).
    • 50  McIntyre DC, Gilby KL: Genetically seizure-prone or seizure-resistant phenotypes and their associated behavioral comorbidities. Epilepsia48(Suppl. 9),30–32 (2007).
    • 51  Hermann B, Seidenberg M, Sager M et al.: Growing up with epilepsy: the neglected issue of cognitive and brain health in aging and elder persons with chronic epilepsy. Epilepsia49,731–740 (2008).
    • 52  Levisohn PM: The autism–epilepsy connection. Epilepsia48(Suppl. 9),33–35 (2007).