Welfare consequences for people with epilepsy and their partners: A matched nationwide study in Denmark

Jennum, Poul; Sabers, Anne; Christensen, Jakob; Ibsen, Rikke; Kjellberg, Jakob

doi:10.1016/j.seizure.2017.05.007

Cited by 29 publications

(27 citation statements)

References 32 publications

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“…The mortality rate of SDRE in patients within 3 years was 14%, which is seven times the rate for a control population matched for age and gender. The increased mortality is high and in line with a recently published, matched nationwide study from Denmark reporting mortality among epilepsy patients of more than 10% 3 years after diagnosis of epilepsy ( 53 ). Causes of death among people with epilepsy are manifold.…”

Section: Discussionsupporting

confidence: 86%

The Burden of Severely Drug-Refractory Epilepsy: A Comparative Longitudinal Evaluation of Mortality, Morbidity, Resource Use, and Cost Using German Health Insurance Data

Strzelczyk

Griebel²,

Lux³

et al. 2017

Front. Neurol.

109

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PurposeTo evaluate long-term outcome of three years and treatment patterns of patients suffering from severely drug-refractory epilepsy (SDRE).MethodsThis analysis was population-based and retrospective, with data collected from four million individuals insured by statutory German health insurance. ICD-10 codes for epilepsy (G40*) and intake of anticonvulsants were used to identify prevalent cases, which were then compared with a matched cohort drawn from the population at large. Insurance data were available from 2008 to 2013. Any patient who had been prescribed with at least four different antiepileptic drugs (AEDs) in an 18-month period was defined as an SDRE case.ResultsA total of 769 patients with SDRE were identified. Of these, 19% were children and adolescents; the overall mean age was 42.3 years, 45.4% were female and 54.6% male. An average of 2.7 AEDs per patient was prescribed during the first follow-up year. The AEDs most commonly prescribed were: levetiracetam (53.5%), lamotrigine (41.4%), valproate (41.3%), lacosamide (20.4%), and topiramate (17.8%). During 3-year follow-up, there was an annual rate of hospitalization in the range 42.7 to 55%, which was significantly higher than the 11.6–12.8% (p < 0.001) for the matched controls. Admissions to hospital because of epilepsy ranged between 1.7 and 1.9 per year, with an average duration for each epilepsy-caused hospitalization of 10–11.1 days. The number of comorbidities for SDRE patients was significantly increased compared with the matched controls: depression (28% against 10%), vascular disorders (22% against 5%), and injury rates were also higher (head 16% against 3%, trunk and limbs 16% against 8%). The 3-year mortality rate for SDRE patients was 14% against 2.1% in the matched cohort.ConclusionSDRE patients are treated with AED polytherapy for all of the 3-year follow-up period. They are hospitalized more frequently than the general population and show increased morbidity levels and a sevenfold increase in mortality rate over 3 years. Further examination is required of ways in which new approaches to treatment could lead to better outcomes in severely affected patients.

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Section: Discussionsupporting

confidence: 86%

The Burden of Severely Drug-Refractory Epilepsy: A Comparative Longitudinal Evaluation of Mortality, Morbidity, Resource Use, and Cost Using German Health Insurance Data

Strzelczyk

Griebel²,

Lux³

et al. 2017

Front. Neurol.

109

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“…We found a higher mortality rate in this small population of patients with PNES than in controls. Several factors are responsible for the elevated mortality rates found in childhood, adolescent, and adult epilepsy [1,34], including seizure severity, underlying diseases, medication, comorbidities, and life-style factors [35][36][37]. A previous study also reported greater mortality in PNES [38].…”

Section: Discussionmentioning

confidence: 94%

Morbidity and mortality of nonepileptic seizures (NES): A controlled national study

Jennum

Ibsen²,

Kjellberg³

2019

Epilepsy & Behavior

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Nonepileptic seizures (NES, psychogenic NES-PNES) are associated with significant morbidities. We evaluated the morbidities and mortality in a national group of children, adolescent, and adult patients before and after a first diagnosis of PNES. Methods: From the Danish National Patient Registry (1998-2013), we identified 1057 people of all ages with a diagnosis of NES and matched them with 2113 control individuals by age, gender, and geography. Comorbidities were calculated three years before and after diagnoses. Results: Patients with PNES showed increased comorbidities 3 years before and after diagnosis in almost all the diagnostic domains. The strongest associations were identified with other neurological diseases (after diagnosis,

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“…Epilepsy is characterized by frequent and unpredictable disruptions of brain functions resulting in “epileptic seizures.” Epilepsy has a great impact on the quality of life through increased incidence of injury and death, unemployment rates, lower monthly incomes, higher household costs and high absenteeism at work and schools (Jennum et al, 2017 ; Trinka et al, 2018 ; Wibecan et al, 2018 ). An epileptic seizure is considered as a transient episode of signs or symptoms, including transitory confusion, staring speech, irrepressible jerking movements, loss of consciousness, psychic symptoms such as fear and anxiety, due to the abnormal synchronous neuronal activity of the brain.…”

Section: Introductionmentioning

confidence: 99%

Sleep Related Epilepsy and Pharmacotherapy: An Insight

et al. 2018

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In the last several decades, sleep-related epilepsy has drawn considerable attention among epileptologists and neuroscientists in the interest of new paradigms of the disease etiology, pathogenesis and management. Sleep-related epilepsy is nocturnal seizures that manifest solely during the sleep state. Sleep comprises two distinct stages i.e., non-rapid eye movement (NREM) and rapid eye movement (REM) that alternate every 90 min with NREM preceding REM. Current findings indicate that the sleep-related epilepsy manifests predominantly during the synchronized stages of sleep; NREM over REM stage. Sleep related hypermotor epilepsy (SHE), benign partial epilepsy with centrotemporal spikes or benign rolandic epilepsy (BECTS), and Panayiotopoulos Syndrome (PS) are three of the most frequently implicated epilepsies occurring during the sleep state. Although some familial types are described, others are seemingly sporadic occurrences. In the present review, we aim to discuss the predominance of sleep-related epilepsy during NREM, established familial links to the pathogenesis of SHE, BECTS and PS, and highlight the present available pharmacotherapy options.

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Welfare consequences for people with epilepsy and their partners: A matched nationwide study in Denmark

Abstract: Epilepsy has major socioeconomic consequences for individual patients, their partners and society.

Cited by 29 publications

References 32 publications

The Burden of Severely Drug-Refractory Epilepsy: A Comparative Longitudinal Evaluation of Mortality, Morbidity, Resource Use, and Cost Using German Health Insurance Data

The Burden of Severely Drug-Refractory Epilepsy: A Comparative Longitudinal Evaluation of Mortality, Morbidity, Resource Use, and Cost Using German Health Insurance Data

Morbidity and mortality of nonepileptic seizures (NES): A controlled national study

Sleep Related Epilepsy and Pharmacotherapy: An Insight

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