The Epidemiology of the Comorbidity of Epilepsy in the General Population

Abstract

Summary:Purpose: To describe the epidemiology of somatic and psychiatric conditions in adults with epilepsy in the community and compare it to that of people without epilepsy.Methods: A cross-sectional population-based study extracting data from the UK General Practice Research Database for the period 1995-1998. Age-and sex-standardized prevalence rates were estimated for selected conditions and groups of conditions (categorized by ICD-9 chapters) in adults with epilepsy registered with primary care physicians. Results were compared with those in adults without epilepsy in the cohort, and prevalence ratios were calculated according to two broad age groups (16-64 and older than 64 years).Results: Conditions common in the general population also were common in adults with epilepsy. Psychiatric disorders occurred twice as often, and the risk of somatic disorders was increased in people with epilepsy, with the exception of musculoskeletal and connective tissue disorders in older adults. The prevalence ratio of neoplasia, excluding intracranial tumors, was not increased in epilepsy. The prevalence ratio of brain tumors was particularly increased in young adults [prevalence ratio (PR), 70.7] and of meningiomas in older adults (PR, 91.9). Neurodegenerative conditions, particularly dementias and Alzheimer' disease (PR, 6.3 and 8, respectively) and Parkinson' disease (PR, 3.2), appeared more frequently in people with epilepsy. Upper gastrointestinal bleed occurred more frequently in epilepsy (PR, 4.3), as did cardio-and cerebrovascular disorders, fractures, pneumonia and chronic lung diseases, and diabetes. Eczema, osteoarthritis, and rheumatoid arthritis did not occur more frequently in epilepsy.Conclusions: The prevalence ratio of many common psychiatric and somatic conditions is increased in adults with epilepsy who consult a primary care physician in the U.K. These findings may have implications in the diagnosis and management of epilepsy and coexisting conditions, as well as in health care provision.

Effect of gender on the pharmacokinetics of eslicarbazepine acetate (BIA 2‐093), a new voltage‐gated sodium channel blocker

“…Genderrelated behaviour regarding drug disposition is an important issue in epilepsy and bipolar disorder, indications in which eslicarbazepine acetate is being developed, because women represent at least half of these patient populations [6,13]. Evidence of gender-related differences in pharmacokinetics abounds, but the mechanisms involved are complex and often poorly understood.…”

“…The trial consisted of one period (Phase A) during which participants were administered a single oral 600 mg dose of eslicarbazepine acetate followed by a period (Phase B) during which participants were give a once-daily oral 600 mg dose for 8 days (days [5][6][7][8][9][10][11][12]. In Phase A, the subjects were admitted to the unit on day 0 (the day before the dosing) and remained under clinical supervision until at least 24 h post-dose (day 2); then, they left and attended the unit in the evening and the morning of days 3-5 for blood sampling and other study procedures.…”

“…The prevalence of epilepsy is similar between males and females [6], and in clinical practice anticonvulsants are prescribed to both male and female patients. In 1993 the Food and Drug Administration (FDA) issued a guidance document requiring the inclusion of both genders in the clinical development of new drugs and in 1998 the FDA policy was confirmed by a report of the FDAMA (FDA Modernisation Act) Women and Minorities Working Group [7], requiring that new drug applications must include data on safety and effectiveness by sex.…”

Epilepsy and quality of life: socio-demographic and clinical aspects, and psychiatric co-morbidity

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Epileptic patients suffer from prejudice and limitations that can compromise their social integration, and hence present a greater incidence of psychiatric co-morbidities when compared to the general population and to individuals with other chronic diseases [1][2][3] .It is known that epilepsy has a great impact on the quality of life (QoL) [4][5][6] . However, how the socio-demographic variables, clinical aspects of epilepsy and the psychiatric co-morbidities act on the QoL has still not been completely elucidated, nor which specific domains would be more involved 5,7-10 .

The performance of epileptic individuals is inferior in QoL evaluations and diverges in various aspects from that of individuals with other chronic diseases 5,11 or from that of the general population 6,7,12 .

Among specific instruments for epilepsy, the Quality of Life in Epilepsy Inventory (QOLIE-31) 13 is one of the most used instruments, and was validated in 2007 for use in the Brazilian population 14 .

The QoL scales possess a subjective construct and, if evaluated judiciously, can provide contributions for medical orientation and can influence health practices and policies.

Study carried out at Faculdade de Medicina, Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas SP, Brazil.

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“…Epileptic patients suffer from prejudice and limitations that can compromise their social integration, and hence present a greater incidence of psychiatric co-morbidities when compared to the general population and to individuals with other chronic diseases [1][2][3] .…”