Epilepsy is often associated with other health problems

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Many people with epilepsy also have other serious comorbidities, such as heart disease and cancer, at higher rates than the general population, U.S. health officials said Thursday.

Worse, these comorbidities are often ignored or undertreated by doctors and patients, according to the Centers for Disease Control and Prevention.

Many people with epilepsy not only live with epilepsy, but also with cardiovascular, respiratory, inflammatory, and other conditions,” said CDC public health analyst Rosemarie Kobau, a co-author of the report.

The new study, based on responses to the 2010 National Health Interview Survey, was published Nov. 1 in the CDC’s Morbidity and Mortality Weekly Report.

Approximately 2.3 million adults in the United States have epilepsy. Epilepsy is a seizure disorder, and its causes and severity vary widely. While controlling epileptic seizures is most important, prevention and treatment are also essential, as these new health problems can shorten life expectancy and increase health care costs, Kobau said.

The difficulty in controlling epilepsy can cause other problems to take a backseat, Kobau said. Because epilepsy is so difficult to treat, secondary conditions are often neglected.

This is a problem for many patients with chronic conditions. If a patient is undergoing chemotherapy for cancer, arthritis symptoms may be neglected,” Cobau explained.

Of the survey respondents, about 20 percent of those with epilepsy reported a history of heart disease. In addition, about half of those with epilepsy reported having had an asthma attack in the past year, while about one-third of adults without epilepsy said they had never had an asthma attack.

Cancer was more common among adults with epilepsy than among adults without epilepsy (about 11% vs. 8%). Hypertension and diabetes were also more common in adults with epilepsy than in adults without epileptic seizures.

Ulcers, arthritis, and other types of pain were also reported more frequently in adults with epilepsy.

Janice Buelow, vice president for programs and research at the Epilepsy Foundation, said the report is a wake-up call for the epilepsy community.

We know that people with epilepsy have higher rates of smoking and tend to be overweight,” Buelow said. However, “we tend to forget that epilepsy is a chronic disease. All we want to do is count the number of seizures.

There are many reasons why people with epilepsy have additional health problems, says Kobau. For example, stroke, migraine, and headaches are associated with the risk of epilepsy, she noted.

In addition, some medications used to control epileptic seizures can cause weight gain and elevated cholesterol levels, which together increase the risk of heart disease and other conditions, Cobau noted.

In addition, epilepsy is stigmatized, and many patients may be socially disadvantaged, Kobau noted. Many people with epilepsy have low socioeconomic status and high unemployment rates.

Doctors have an important role to play in dealing with the comorbidity of epilepsy. We need to recognize how common these problems are in epilepsy patients and better screen, diagnose, and treat them,” Kobau concluded. Patients also have a role to play in controlling and preventing other chronic diseases.

Epilepsy patients should develop healthy lifestyle habits, smokers should quit, they should talk to their doctors about safe physical activity options, they should eat a healthy diet and strive to maintain a healthy weight, they should get good sleep, and they should work to reduce stress,” Dr. Kobau stated.

Drs. Cynthia Harden, director of the Comprehensive Epilepsy Care Center at North Shore LIJ in Manhasset, N.Y., believes that many epilepsy complications are caused by older drugs used to control seizures.

‘I don’t think lifestyle can explain it,’ she said. Since they are using newer antiepileptic drugs, the drugs should be having less of an effect on the patient.”

Harden recommends that physicians reduce their reliance on older epilepsy drugs and “focus on using newer drugs that have fewer side effects.”
These new drugs include Neurotin, Lamictal, Topamax, Zonegran, Keppra, Trileptal, and Gabitril, many of which are now generics.

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