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Conditions Related to Epilepsy

Posted on October 27, 2021
Medically reviewed by
Amit M. Shelat, D.O.
Article written by
Brooke Dulka, Ph.D.

Epilepsy includes a spectrum of seizure disorders caused by abnormal electrical activity in the brain. Approximately 1 percent of the general population has epilepsy, but having a related condition may put you at greater risk. When two or more conditions occur at the same time — such as epilepsy and depression — the conditions are said to be comorbid.

Sometimes, a comorbid disorder occurs alongside epilepsy as a consequence of epilepsy. Other times, a preexisting condition can increase the risk of later developing epilepsy. Epilepsy and comorbid conditions often share underlying biological mechanisms that can increase the risk of either condition.

Managing two conditions at the same time can affect your quality of life. If you have epilepsy, it may help to understand your risk of related conditions so you can work with your doctor or health care team to help prevent or treat the other conditions. Here’s what to know about the comorbidities of epilepsy.

Comorbid Neurological Disorders

Neurological disorders are brain-related conditions. Abnormalities in sodium channels, which help regulate electrical activity in the brain, may be a shared mechanism in many neurological disorders that occur alongside epilepsy.

Alzheimer’s Disease

Alzheimer’s disease is a disease of cognitive decline, brain atrophy, and dementia. Research has found that people who have Alzheimer's disease are at an increased risk of seizures or epilepsy. Approximately 10 percent to 22 percent of people with Alzheimer’s will experience at least one seizure, typically beginning in the later stages of Alzheimer’s disease.

Research in mice has shown that high levels of beta-amyloid protein in the brain (a characteristic trait of Alzheimer’s disease) can cause seizure activity. This finding has led experts to believe that Alzheimer’s disease may be a risk factor for epilepsy development.

Migraine

Migraines cause intense headaches accompanied by sensitivity to light, nausea, and other symptoms. Headaches (including migraines) appear at a higher rate in people with epilepsy (52 percent of men and 57 percent of women) compared to the general population (16 percent of men and 28 percent of women). Migraines may share common genetic roots with epilepsy.

Brain Tumors

Brain tumors, particularly gliomas, can cause epilepsy to develop. Approximately 40 percent to 60 percent of people with brain tumors will experience seizures.

Encephalitis

Viral encephalitis is an infection of the brain that causes inflammation. Like brain tumors, encephalitis can cause epilepsy. The frequency of seizures in cases of encephalitis ranges from 7 percent to 46 percent.

Cerebrovascular Disease

Cerebrovascular disease refers to a variety of conditions that disrupt blood flow or damage blood vessels within the brain. Problems with blood flow can lead to stroke. According to the Epilepsy Foundation, strokes are the most common cause of epilepsy in the elderly and account for 22 percent to 69 percent of seizures in this age group.

Comorbid Cognitive and Psychiatric Disorders

Several psychiatric and cognitive disorders are related to epilepsy, including attention deficit hyperactivity disorder (ADHD), depression, anxiety, autism, and psychosis.

Attention Deficit Hyperactivity Disorder

ADHD is a disorder of attention and impulsiveness that affects children and adults. ADHD has been shown to occur at a higher rate in children with epilepsy than in the general population. Among all children, rates of ADHD are approximately 9 percent. Research has shown that the rate of ADHD in children with epilepsy, however, is between 27 percent and 40 percent, making ADHD one of the most common psychiatric comorbidities of childhood epilepsy.

Depression

Depression is a mood disorder related to feelings of sadness. Overall, people with epilepsy tend to have depression at higher rates than people without epilepsy. Changes in the brain chemical messengers (neurotransmitters) norepinephrine and serotonin may underlie features of both depression and epilepsy.

Anxiety Disorder

Epilepsy may result in the development of anxiety, a psychiatric condition that causes excessive worry and fear. Anxiety has been reported to occur in approximately 23 percent of people with epilepsy, compared to 11 percent in the general population. Because anxiety medications can be used to treat epilepsy and antiepileptic drugs can be used for anxiety, scientists believe that the conditions also share similar brain biology underpinnings.

Autism

Autism, or autism spectrum disorder, is a developmental disorder of communication. Neurotypical children (children without autism) experience epilepsy rates around 1 percent to 2 percent. However, in children with autism, the rate of epilepsy is around 30 percent. This relationship is likely due to shared genetic risk factors, as research shows that autism and epilepsy share 20 genes.

Psychosis

Psychosis, or when a person loses contact from reality and experiences delusions, can be a symptom of epilepsy. Research shows that people with epilepsy are at eight times the risk of psychosis than the general population.

Comorbid Sleep Disorders

Insomnia and sleep apnea are two sleep disorders that are associated with epilepsy.

Insomnia

Insomnia is a chronic problem of not being able to fall asleep or stay asleep. Insomnia can occur as a symptom of epilepsy. In one study, 55 percent of people with epilepsy experienced insomnia.

Sleep Apnea

Sleep apnea, or obstructive sleep apnea, is a serious condition in which a person repeatedly stops breathing while sleeping. According to one study, about 30 percent of individuals with epilepsy also experienced sleep apnea. The typical treatment for sleep apnea is continuous positive airway pressure (CPAP). CPAP use has also been shown to reduce seizure activity.

Comorbid Autoimmune Disorders

Autoimmune disorders also frequently occur in the context of epilepsy. The International League Against Epilepsy classification system suggests that there may be an immune component of epilepsy that could explain the association between epilepsy and some autoimmune disorders.

Type 1 Diabetes Mellitus

Doctors and researchers have noticed a relationship between type 1 diabetes mellitus (a condition in which the pancreas does not produce enough insulin) and epilepsy. Studies show that approximately 25 percent of people with diabetes also experience epilepsy, whereas epilepsy occurs in approximately 1 percent of the general population. Some scientists believe that changes in brain metabolism related to low blood sugar levels may be the link between these two conditions.

Thyroid Disorders

A thyroid disorder is a condition involving the dysregulation of thyroid hormones, which contribute to many functions in the body. Thyroid conditions and epilepsy have both been linked to mitochondrial dysfunction and oxidative stress. Some research suggests that thyroid disorders may lead to the development of epilepsy.

Myasthenia Gravis

A chronic weakness of skeletal muscles known as myasthenia gravis has also been observed in people with epilepsy. One study shows that about 3 percent of people with epilepsy also experience myasthenia gravis, a condition that affects less than 1 percent of the general population.

Multiple Sclerosis

Multiple sclerosis (MS) is an autoimmune disease that attacks the brain and spinal cord. This condition occurs more frequently than by chance in people with epilepsy. Some researchers suspect that MS lesions in the brain can act as a focal point for an epileptic seizure.

Lupus

Lupus is an autoimmune disease involving inflammation and pain in connective tissues. Research shows that people with lupus are at nearly a sixfold risk of developing epilepsy compared to people without lupus.

Other Medical Comorbidities

Other medical conditions have also been shown to be comorbid with epilepsy. These disorders related to epilepsy include:

  • Musculoskeletal system disorders
  • Gastrointestinal and digestive disorders
  • Respiratory system disorders
  • Chronic pain disorders
  • Neoplasia
  • Arthritis
  • Obesity
  • Fractures
  • Allergies

Talk To Your Doctor About Related Conditions

Your doctor can help you understand your risk factors for developing related conditions. The doctor can also recommend steps to manage or lower your risk. Always make sure your health care provider is aware of every medication you are taking for any condition, whether the medication is available over the counter or by prescription, including any vitamins or herbal supplements. Some medications can cause dangerous interactions. Open communication with your doctor ensures you can be partners in decision-making about your health.

Condition Guide

References
  1. Epilepsy — Mayo Clinic
  2. Characteristic Distribution of Interictal Brain Electrical Activity in Idiopathic Generalized Epilepsy — Epilepsia
  3. Defining Comorbidity: Implications for Understanding Health and Health Services — Annals of Family Medicine
  4. Depression in Epilepsy — Neurology
  5. Association of Epilepsy and Comorbid Conditions — Future Neurology
  6. Sodium Channel Mutations in Epilepsy and Other Neurological Disorders — The Journal of Clinical Investigation
  7. Epilepsy and Cognitive Impairments in Alzheimer Disease — Archives of Neurology
  8. What Is Alzheimer’s Disease? — Alzheimer’s Association
  9. Aberrant Excitatory Neuronal Activity and Compensatory Remodeling of Inhibitory Hippocampal Circuits in Mouse Models of Alzheimer's Disease — Neuron
  10. Amyloid Cascade Hypothesis: Pathogenesis and Therapeutic Strategies in Alzheimer's Disease — Neuropeptides
  11. Seizures in Elderly Patients With Dementia: Epidemiology and Management — Drugs & Aging
  12. Evidence of Shared Genetic Risk Factors for Migraine and Rolandic Epilepsy — Epilepsia
  13. Migraines — Mayo Clinic
  14. Evidence for a Shared Genetic Susceptibility to Migraine and Epilepsy — Epilepsia
  15. High Prevalence of Headaches in Patients With Epilepsy — The Journal of Headache and Pain
  16. Epilepsy-Related Brain Tumors — Seizure
  17. Seizure Prognosis in Brain Tumors: New Insights and Evidence-Based Management — The Oncologist
  18. Viral Encephalitis and Epilepsy — Epilepsia
  19. Cerebrovascular Disease — University of Michigan Health
  20. Cerebrovascular Disease — Epilepsy Foundation
  21. What Is ADHD? — Centers for Disease Control and Prevention
  22. Prevalence of Epilepsy and Attention-Deficit Hyperactivity (ADHD) Disorder: A Population-Based Study — Journal of Child Neurology
  23. Childhood Epilepsy, Attention Problems, and ADHD: Review and Practical Considerations — Seminars in Pediatric Neurology
  24. Measures of Psychopathology in Children With Complex Partial Seizures and Primary Generalized Epilepsy With Absence — Journal of the American Academy of Child and Adolescent Psychiatry
  25. Depression — National Institute of Mental Health
  26. Depression in Epilepsy: A Neurobiologic Perspective — Epilepsy Currents
  27. Anxiety — Epilepsy Foundation
  28. Psychiatric Comorbidity in Epilepsy: A Population-Based Analysis — Epilepsia
  29. Using Anxiolytics in Epilepsy: Neurobiological, Neuropharmacological and Clinical Aspects — Epileptic Disorders
  30. What Is Autism? — Autism Speaks
  31. Epilepsy in Autism — The Lancet Neurology
  32. Multiplex Gene and Phenotype Network to Characterize Shared Genetic Pathways of Epilepsy and Autism — Scientific Reports
  33. What Is Psychosis? — National Institute of Mental Health
  34. Psychosis — Epilepsy Foundation
  35. The Prevalence of Psychosis in Epilepsy; A Systematic Review and Meta-Analysis — BMC Psychiatry
  36. Comorbidity Between Epilepsy and Sleep Disorders — Epilepsy Research
  37. Insomnia — Mayo Clinic
  38. Insomnia and Epilepsy: A Questionnaire-Based Study — Journal of Clinical Sleep Medicine
  39. Obstructive Sleep Apnea — Mayo Clinic
  40. Effect of Continuous Positive Airway Pressure Treatment on Seizure Control in Patients With Obstructive Sleep Apnea and Epilepsy — Epilepsia
  41. Epilepsy and Autoimmune Diseases: Comorbidity in a National Patient Cohort — Seizure
  42. ILAE Classification of the Epilepsies: Position Paper of the ILAE Commission for Classification and Terminology — Epilepsia
  43. Type 1 Diabetes — Mayo Clinic
  44. Association Between Seizures and Diabetes Mellitus: A Comprehensive Review of Literature — Current Diabetes Reviews
  45. Metabolic Brain Adaptations to Recurrent Hypoglycaemia May Explain the Link Between Type 1 Diabetes Mellitus and Epilepsy and Point Towards Future Study and Treatment Options — Diabetologia
  46. Thyroid Disease — Cleveland Clinic
  47. Thyroid Hormones: Possible Roles in Epilepsy Pathology — Seizure
  48. Myasthenia Gravis Fact Sheet — National Institute of Neurological Disorders and Stroke
  49. Treatment of Epilepsy in Patients With Myasthenia Gravis: Is Really Harder Than It Looks? — Journal of Clinical Neuroscience
  50. Multiple Sclerosis — Mayo Clinic
  51. Association Between Multiple Sclerosis and Epilepsy: Large Population-Based Record-Linkage Studies — BMC Neurology
  52. What Is Lupus? — Lupus Foundation of America
  53. Comorbidities of Pediatric Systemic Lupus Erythematosus: A 6-Year Nationwide Population-Based Study — Journal of Microbiology, Immunology and Infection
  54. Data and Statistics About ADHD — Centers for Disease Control and Prevention
  55. Epilepsy — World Health Organization
  56. Myasthenia Gravis — National Organization for Rare Disorders

A MyEpilepsyTeam Member said:

Hello, Thanks for the information, Take Care.

posted about 1 month ago

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Amit M. Shelat, D.O. is a fellow of the American Academy of Neurology and the American College of Physicians. Review provided by VeriMed Healthcare Network. Learn more about him here.
Brooke Dulka, Ph.D. is a freelance writer at MyHealthTeams. Learn more about her here.

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