Psychiatric comorbidities and memory problems have a big impact on the quality of life in people with relatively well-controlled epilepsy.
According to almost 1,000 responses from an online survey of Australians with epilepsy – the majority of whom were seizure free for more than a year – comorbidities and adverse events were common.
Psychiatric comorbidities, including depression and anxiety, were the most common (46%), followed by pain (44%), respiratory issues such as asthma (39%), cardio-cerebrovascular disease (27%) and movement disorders or tremor (14%).
“Psychiatric disorders were associated with the largest difference in QoL score (−23.14 [95% confidence interval (CI): − 25.93, − 20.34]), followed by movement disorder/tremor (− 5.08 [− 8.95, − 1.21]), and pain (− 4.94 [− 7.62, − 2.26]),” the study said.
“In our analysis, the association between psychiatric comorbidities and decreased QoL was significant even after controlling for seizure frequency, the number of current and lifetime AEDs prescribed, and other proxies for disease severity.”
Respondents also reported that the most common adverse events were sleep problems (89%), memory problems ( 68%), headache (54%) and unsteadiness (50%). The mean number of adverse events per respondent was 5.1.
“Self-reported memory problems were associated with the largest difference in QoL (− 14.27 [95% CI: − 17.02, − 11.53]), followed by unsteadiness (− 4.89 [− 7.53, − 2.26]), sleep problems (− 4.68 [− 8.75, − 0.60]), and gastrointestinal issues (− 3.79 [− 6.41, − 1.17]).”
“Our study highlights that memory problems can remain a significant concern even among relatively well-controlled PwE; one possible interpretation is that high-functioning or reasonably controlled PwE may be more sensitive to cognitive issues, and are thus more likely to report and be affected by them than a more severe sample who are more focused on managing seizure control.”
“As sleep problems have been widely associated with memory issues and mood/anxiety disorders, this also further reinforces the possible negative effects of these interrelated issues among PwE.”
The authors, including senior investigator Associate Professor Wendyl D’Souza, said further research was needed to explore the complex interrelationships between symptoms.
For example, relationships between epilepsy and comorbidities such as migraine headaches may be bidirectional.
“Future prospective studies would help to further clarify causality between the variables, including relationships between possibly interrelated or overlapping symptoms, and to account for individual medication effects.”
The study, published in Epilepsy & Behavior, was funded by UCB Pharma.