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3 New Findings on Epilepsy

ADHD lowers the quality of life in adults with epilepsy; epilepsy is associated with social deprivation and increased risk of venous thromboembolism: details of these recent findings in this slide show.

Scientists are studying the underlying causes of epilepsy and the seizures that occur after brain trauma, stroke, and brain tumors, says the NIH. Ongoing research is focused on developing new model systems to more quickly screen potential new treatments. Identification of genetic information that may cause epilepsy may help doctors prevent the disorder or predict which treatments will be most beneficial.Recent epilepsy study findings -- highlighted in these slides -- include:
• About one-fifth of patients with epilepsy have ADHD, which is associated with lower quality of life.
• Social deprivation appears to be a cause of epilepsy.
• The risk of venous thromboembolism is higher in patients with epilepsy.

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Adults in the United States who self-reported they had epilepsy received a postal survey that included the Adult Attention-deficit/hyperactivity disorder (ADHD) Self-Report Scale version 6 (ASRS-6) and the Quality of Life in Epilepsy Inventory-10. There were 1361 respondents with active epilepsy (reporting current prescription medication use for epilepsy).Source: Ettinger AB, Ottman R, Lipton RB, et al. Attention-deficit/hyperactivity disorder symptoms in adults with self-reported epilepsy: results from a national epidemiologic survey of epilepsy. Epilepsia. 2015;56:218-224.

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Patients with ASRS-6 scores > 14 were classified as having ADHD and those with lower scores as not having ADHD. 18.4% (n = 251) of respondents were classified as having ADHD. Compared with ADHD-negative cases, patients with ADHD were more likely to have elevated depression and anxiety scores as well as greater seizure frequency and more antiepileptic drug use.Source: Ettinger AB, Ottman R, Lipton RB, et al. Attention-deficit/hyperactivity disorder symptoms in adults with self-reported epilepsy: results from a national epidemiologic survey of epilepsy. Epilepsia. 2015;56:218-224.

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Statistical modeling results that compared persons with and without ADHD indicated that those with ADHD had a lower quality of life. ADHD symptoms occur in nearly 1 in 5 adults with epilepsy and are associated with increased psychiatric morbidity and lowered quality of life.Source: Ettinger AB, Ottman R, Lipton RB, et al. Attention-deficit/hyperactivity disorder symptoms in adults with self-reported epilepsy: results from a national epidemiologic survey of epilepsy. Epilepsia. 2015;56:218-224.http://onlinelibrary.wiley.com/doi/10.1111/epi.12897/abstract.

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Study authors reviewed electronic primary health care records in Wales, UK, from 2004 to 2010 to identify prevalent and incident cases of epilepsy and linked deprivation scores (Welsh Index of Multiple Deprivation). Between 2004 and 2010, 8.1 million patient-years of records were reviewed, representing 40% of the population of Wales.Source: Pickrell WO, Lacey AS, Bodger OG, et al. Epilepsy and deprivation, a data linkage study. Epilepsia. Article first published online: 2 Mar 2015. DOI: 10.1111/epi.12942.

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Epilepsy prevalence ranged from 1.13% (1.07-1.19%) in the most deprived decile to 0.49% (0.45-0.53%) in the least deprived decile. Epilepsy incidence ranged from 40/100,000 per year in the most deprived decile to 19/100,000 per year in the least deprived decile.Source: Pickrell WO, Lacey AS, Bodger OG, et al. Epilepsy and deprivation, a data linkage study. Epilepsia. Article first published online: 2 Mar 2015. DOI: 10.1111/epi.12942.

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There was no statistically significant change in deprivation index decile 10 years after a new diagnosis of epilepsy, suggesting that epilepsy does not cause a lowered deprivation. These findings suggest that increasing rates of epilepsy in deprived areas are more likely explained by social causation.Source: Pickrell WO, Lacey AS, Bodger OG, et al. Epilepsy and deprivation, a data linkage study. Epilepsia. Article first published online: 2 Mar 2015. DOI: 10.1111/epi.12942.http://onlinelibrary.wiley.com/doi/10.1111/epi.12942/abstract

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The authors reviewed all inpatient, emergency department, and hospital-based outpatient encounters in South Carolina from January 1, 2000 through December 31, 2011 for the primary outcome variable of venous thromboembolism (VTE) in patients after an initial diagnosis of epilepsy or migraine. A total of 138,497 patients with migraine and 67,900 patients with epilepsy were included. VTE occurred in 2.7% of patients with epilepsy and 0.6% of patients with migraine.

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The hazard ratio for VTE in patients with epilepsy compared with patients with migraine was 3.08 (95% CI 2.76-3.42), adjusted for all covariables. A higher VTE risk in patients with epilepsy than patients with migraine suggests risk factors associated with epilepsy that increase VTE risk, independent of chronic neurologic illness. Source: Martz GU, Wilson DA, Malek AM, Selassie AW. Risk of venous thromboembolism in people with epilepsy. Epilepsia. 2014;55:1800-1807.http://onlinelibrary.wiley.com/doi/10.1111/epi.12796/abstract.

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