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Epilepsy and Related Conditions
Dr. Jonathan C. Edwards, chair of the Department of Neurology at the Medical University of South Carolina, talks about are other neurological conditions related to epilepsy.
00:00:00:00 - 00:00:36:01
Mary Ray
If someone has epilepsy, is there a chance they're likely to have other neurological issues? For instance, Kathleen wants to know if someone with epilepsy has a higher chance of getting a condition like Alzheimer's or A.D.D.? Yeah. Well, certainly patients with epilepsy can have other neurological conditions. One of the most common, what we call comorbid conditions, or a neurological condition or something that you also get in addition to epilepsy. A lot of patients with epilepsy have migraine or other headaches.
00:00:36:03 - 00:01:08:11
Dr. Jonathan Edwards
There's increased incidence of migraine in patients with epilepsy much higher than there is in the general population. Desiree asked, was it Desiree or who asked about Alzheimer's disease? It's been known now for decades that patients with Alzheimer's disease are more likely to develop seizures than age matched controls. So patients of similar age that don't have Alzheimer's disease are less likely to have seizures than people with Alzheimer's disease.
00:01:08:12 - 00:01:28:08
Dr. Jonathan Edwards
And if you think about it, the part of the brain is affected very heavily by Alzheimer's disease is also the inside part of the temporal lobe, an area called the hippocampus. and when that area is injured, you can have seizures as a consequence of that. So the underlying process that's causing Alzheimer's disease can also cause seizures.
00:01:28:10 - 00:01:50:14
Dr. Jonathan Edwards
What we have learned over the last few years is that patients with uncontrolled epilepsy over time do have a slightly increased risk of dementia later on, especially uncontrolled temporal lobe epilepsy. And if you think about it, the part of the brain that's injured in temporal lobe epilepsy is also the part of brain that processes memory,
00:01:50:19 - 00:02:26:05
Dr. Jonathan Edwards
so that would also kind of make sense. Additionally, on top of migraine, one of the other common conditions that what we call comorbid conditions that goes along with epilepsy is depression, and that can be for one of many reasons. Just mention really quickly that a lot of people don't know about is something we refer to as seizure worry, which is when patients can almost be disabled by the fact that they're terrified of the next seizure because of that loss of control and that lack of predictability.
00:02:26:07 - 00:02:52:18
Dr. Jonathan Edwards
And sometimes that worry, you know, I haven't had a seizure in four years, but what if I have one while I'm driving? You know, that kind of just worry and anxiety can really cause an impact on patient's quality of life. There is an effective treatment for that, something called cognitive behavioral therapy can actually help with that too.
Epilepsy is a group of seizure disorders caused by unusual electrical activity in the brain. About 1 percent of the general population has epilepsy. Having another health condition may raise your risk. When two or more conditions happen at the same time — like epilepsy and depression — they are called comorbid conditions.
Sometimes, a comorbid condition happens with epilepsy as a result of the condition. Other times, a preexisting condition can increase the risk of later developing epilepsy. Epilepsy and comorbid conditions can be linked because they sometimes start from the same changes in the body. This means that having one can raise the risk of getting the other.
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 healthcare team to help prevent or treat the other conditions. Here’s what to know about the comorbidities of epilepsy.
Neurological disorders are brain-related conditions. Abnormalities in brain channels (tiny parts that help control electrical activity in the brain) can happen in many brain disorders associated with epilepsy.
Alzheimer’s disease is a condition that causes memory loss, thinking problems, and dementia (changes in the brain). 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. Because of this finding, health experts think Alzheimer’s disease may be a risk factor for developing epilepsy.
Migraine causes intense headaches with sensitivity to light, nausea, and other symptoms. Headaches, including migraines, are more common in people with epilepsy (52 percent of men and 57 percent of women) than in the general population (16 percent of men and 28 percent of women). Migraines and epilepsy may both be caused by changes in the same genes.
Brain tumors, particularly gliomas, can cause epilepsy to develop. Approximately 40 percent to 60 percent of people with brain tumors will experience seizures.
Encephalitis is an inflammation of the brain that can be caused by infection. Like brain tumors, encephalitis can cause seizures and epilepsy. Seizures happen in 7 percent to 46 percent of people with encephalitis.
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 a stroke. According to the Epilepsy Foundation, strokes are the most common cause of seizures for people over 60.
Several psychiatric (mental health) and cognitive (problems with thinking or learning) disorders are related to epilepsy, including attention deficit hyperactivity disorder (ADHD), depression, anxiety, autism, and psychosis.
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 11.4 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 is a mood disorder related to feelings of sadness and low energy. Overall, people with epilepsy tend to have depression at higher rates than people without epilepsy. Changes in the brain’s chemical messengers (neurotransmitters), norepinephrine and serotonin, may underlie features of both depression and epilepsy.
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. People with epilepsy may have higher rates of anxiety because of changes in parts of the brain called the hippocampus and amygdala. These areas help control anxiety and can also be where seizures start.
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 features.
Autism, or autism spectrum disorder, is a developmental disorder of communication. Neurotypical children (children without autism) experience epilepsy rates of around 2 percent to 3 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 is when a person loses contact with reality and has false beliefs, called delusions. It can happen during a seizure or in people with epilepsy, even when they aren’t having a seizure. Research shows that people with epilepsy are at eight times the risk of psychosis than the general population.
Insomnia and sleep apnea are two sleep disorders that often occur alongside epilepsy. Conditions like insomnia, sleep-wake disorders, and sleep apnea can make seizures harder to manage and may affect quality of life.
Insomnia is an ongoing problem that makes it hard to fall asleep or stay asleep. In fact, insomnia affects about 55 percent of people with epilepsy.
Sleep-wake disorders involve sleep cycle problems that make it hard to go through all phases of sleep at night. When you have a sleep-wake disorder, you don’t feel well-rested in the morning. The relationship between sleep-wake disorders and epilepsy can go both ways. Epilepsy seizures during the day can lead to sleep cycle problems at night, and sleep-wake disorders can make it harder to manage seizures.
Sleep apnea, or obstructive sleep apnea, is a condition that repeatedly stops a person’s 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), a machine that uses mild air pressure to keep your airways open while you sleep. CPAP use has also been shown to reduce seizure activity.
Autoimmune disorders happen when the immune system attacks the body’s healthy cells by mistake. These disorders also frequently occur alongside epilepsy. The International League Against Epilepsy classification system suggests that epilepsy may be linked to the immune system, which could explain the association between epilepsy and some autoimmune disorders.
Type 1 diabetes mellitus is a condition in which the pancreas doesn’t make enough insulin. Doctors and researchers have noticed a relationship between this condition and epilepsy. Studies show that about 1 out of every 80 people with type 1 diabetes also has epilepsy. This is almost three times higher than in people without diabetes, showing a strong link between the two conditions. Some scientists believe that changes in how the brain uses energy — especially during low blood sugar — might explain the link between these two conditions.
A thyroid disorder happens when the body makes too much or too little thyroid hormone. Thyroid problems and epilepsy are both linked to issues with how cells make and use energy, as well as damage that builds up inside cells. Some research suggests that thyroid disorders may increase the risk of developing epilepsy.
Myasthenia gravis is a long-term condition that causes muscle weakness. It can sometimes happen in people with epilepsy. In one study from Brazil, about 3 out of every 100 people with myasthenia gravis also had epilepsy. However, doctors say that having both conditions together is very rare, and there’s not a lot of information about how often this happens.
Multiple sclerosis (MS) is a disease where the immune system attacks the brain and spinal cord. People with MS are more likely to have epilepsy than people without MS. In a large study from England, about 3 out of every 100 people with MS also had epilepsy, which is higher than an association due to chance. Scientists think that the damage MS causes in the brain might sometimes lead to seizures, but they are still studying exactly how these two diseases are connected.
Lupus is an autoimmune disease involving inflammation and pain in connective tissues. Research shows that people with lupus are at nearly six times the risk of developing epilepsy compared to those without lupus.
Other medical conditions can occur with epilepsy. For example, 60 percent to 80 percent of people with epilepsy report having cardiovascular conditions such as arrhythmias (irregular heartbeats), coronary heart disease, and heart attacks.
Other disorders that can be more common in people with epilepsy include:
Your doctor can help you understand your risk factors for developing related conditions. They can also recommend steps to manage or lower your risk. Always make sure your healthcare provider is aware of every medication you’re taking for any condition, whether it’s available over the counter or by prescription, including any vitamins or herbal supplements. Some treatments can cause harmful interactions. Open communication with your doctor helps you make more informed decisions about your health.
On MyEpilepsyTeam, the social network for people with epilepsy and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with epilepsy.
Do you have conditions related to epilepsy? How do you manage your comorbid conditions? Share your experience in the comments below, or start a conversation by posting on your Activities page.
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IF These Are Related Conditions, Why Is It That My Doctors Haven’t Told Me About These Symptoms? Do They Show Up On An EEG?
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I agree with you and your post and the other people's posts here, but everyone hang in there and try and stay pos and good luck with your condition and health, my opinion , my faith in God I keep,
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