International consensus clinical practice statements for the treatment of neuropsychiatric conditions associated with epilepsy

Abstract

SUMMARYIn order to address the major impact on quality of life and epilepsy management caused by associated neuropsychiatric conditions, an international consensus group of epileptologists met with the aim of developing clear evidence-based and practice-based statements to provide guidance on the management of these conditions. Using a Delphi process, this group prioritized a list of key management areas. These included: depression, anxiety, psychotic disorders, nonepileptic seizures, cognitive dysfunction, antiepileptic drug (AED)-related neurobehavioral disorders, suicidality, disorders in children and adolescents, disorders in children with intellectual disability, and epilepsy surgery. Clinical practice statements were developed for each area and consensus reached among members of the group. The assessment and management of these conditions needs to combine knowledge of psychiatric disorders, knowledge of the impact of epilepsy and its treatment on psychopathology, and an ability to deliver care within epilepsy services. The aim of these statements is to provide guidance on quality care for people with epilepsy that have a range of neuropsychiatric disorders.

A prospective service evaluation of acceptance and commitment therapy for patients with refractory epilepsy

“…It is associated with a wide range of comorbidities, and psychosocial seizures itself. A number of studies have highlighted the psychosocial impacts of epilepsy and emphasised the need for treatments addressing the full spectrum of problems associated with the disorder, rather than focus purely on seizure reduction [3,4,38,39]. However, there is a lack of accessible and cost-effective psychological and behavioural interventions that are supported by high quality empirical evidence.…”

“…The observed improvements of depression and anxiety are particularly encouraging, as depression and anxiety are common comorbidities with a complex, bi-directional relationship with epilepsy which often complicate the management of the disorder [39,40]. Appropriate treatment of comorbid mood disorders has been suggested to have potentially important benefits for both seizure management and improved quality of life [39].…”

“…Appropriate treatment of comorbid mood disorders has been suggested to have potentially important benefits for both seizure management and improved quality of life [39].…”

Anxiety disorders in people with epilepsy

“…Anxiety disorders are even called the "forgotten comorbidity" (Kanner, 2011). The importance of this topic has also recently been underlined by the fact that a workgroup of the International League of Epilepsy has worked on a consensus paper concerning neuropsychiatric conditions in epilepsy, which also included anxiety (Kerr et al, 2011). The current paper aims at giving an overview of relevant aspects of anxiety disorders in epilepsy with a special focus on prevalence, the impact of an anxiety disorder on the affected individual's daily living, and aspects of treatment.…”

Women with epilepsy: clinically relevant issues

“…Psychiatric comorbidity is high in patients with epilepsy (Jones et al, 2010;Kerr et al, 2011), often as a result of AED treatment Eddy et al, 2012;Piedad et al, 2012). The overall prevalence rate of psychiatric conditions in epilepsy ranges between 20-30% and 50-60%, according to different estimates (Jones et al, 2010;Karouni et al, 2010).…”