Epilepsy Linked to Comorbidities Related to Central Nervous System

BOSTON — Certain central nervous system-related comorbidities occur more often among people with self-reported epilepsy than in the general population, according to a large survey of U.S. households.

Individuals who reported ever having had epilepsy or a seizure disorder were more likely than those without a self-reported epilepsy diagnosis to have ever had depression, anxiety, bipolar disorder, attention-deficit/hyperactivity disorder, sleep disorder, or migraine, Ruth Ottman, Ph.D., reported at the annual meeting of the American Epilepsy Society.

Dr. Ottman, professor of epidemiology and neurology at Columbia University, New York, and her colleagues developed an 11-item screening survey that was mailed in 2008 to 340,000 households from two national panels selected to be representative of the U.S. population.

Of the 3,488 people who reported having ever had epilepsy or a seizure disorder, 61% were female, the mean age was 48 years, 35% had a seizure or convulsion within the previous 12 months, and 27% reported having had a febrile seizure or convulsion as a child. In the epilepsy cohort, 33% reported ever having depression, compared with 26% of controls without epilepsy. The epilepsy cohort was more likely to report a history of anxiety disorder (22% vs. 14%), bipolar disorder (14% vs. 7%), and ADHD (13% vs. 6%). The epilepsy cohort also was more likely to report sleep disorder (20% vs. 14%) and migraine (28% vs. 21%).

The survey did not collect information on specific medications, but “it is possible that some of the comorbidity in our study could be related to medications,” Dr. Ottman said in an interview. “However, for several of the comorbid disorders we described, other studies have found significantly increased occurrences even before the first seizure, suggesting that medications do not explain all of the comorbidity.” For example, “the prevalence of depression is higher in people with epilepsy than in people without it, even before the first seizure occurs, and this is also true for migraine.”

A possible explanation for the increased prevalence of certain CNS comorbidities might be a “shared pathogenic mechanism underlying epilepsy and the other disorders, possibly due to shared genetic susceptibilities or to common environmental risk factors,” Dr. Ottman said.

Clinicians should be aware of the potential for CNS-related comorbidities so they can consider medications effective in treating both epilepsy and certain comorbid disorders, she said. Comorbidities have been highlighted by the National Institute of Neurological Disorders and Stroke as a priority for epilepsy research, “and we hope our research will increase awareness of comorbidities.”

Disclosures: Study sponsored by Ortho-McNeil Janssen Scientific Affairs. Dr. Ottman reported no conflicts of interest.

BOSTON — Certain central nervous system-related comorbidities occur more often among people with self-reported epilepsy than in the general population, according to a large survey of U.S. households.

Individuals who reported ever having had epilepsy or a seizure disorder were more likely than those without a self-reported epilepsy diagnosis to have ever had depression, anxiety, bipolar disorder, attention-deficit/hyperactivity disorder, sleep disorder, or migraine, Ruth Ottman, Ph.D., reported at the annual meeting of the American Epilepsy Society.

Dr. Ottman, professor of epidemiology and neurology at Columbia University, New York, and her colleagues developed an 11-item screening survey that was mailed in 2008 to 340,000 households from two national panels selected to be representative of the U.S. population.

Of the 3,488 people who reported having ever had epilepsy or a seizure disorder, 61% were female, the mean age was 48 years, 35% had a seizure or convulsion within the previous 12 months, and 27% reported having had a febrile seizure or convulsion as a child. In the epilepsy cohort, 33% reported ever having depression, compared with 26% of controls without epilepsy. The epilepsy cohort was more likely to report a history of anxiety disorder (22% vs. 14%), bipolar disorder (14% vs. 7%), and ADHD (13% vs. 6%). The epilepsy cohort also was more likely to report sleep disorder (20% vs. 14%) and migraine (28% vs. 21%).

The survey did not collect information on specific medications, but “it is possible that some of the comorbidity in our study could be related to medications,” Dr. Ottman said in an interview. “However, for several of the comorbid disorders we described, other studies have found significantly increased occurrences even before the first seizure, suggesting that medications do not explain all of the comorbidity.” For example, “the prevalence of depression is higher in people with epilepsy than in people without it, even before the first seizure occurs, and this is also true for migraine.”

A possible explanation for the increased prevalence of certain CNS comorbidities might be a “shared pathogenic mechanism underlying epilepsy and the other disorders, possibly due to shared genetic susceptibilities or to common environmental risk factors,” Dr. Ottman said.

Clinicians should be aware of the potential for CNS-related comorbidities so they can consider medications effective in treating both epilepsy and certain comorbid disorders, she said. Comorbidities have been highlighted by the National Institute of Neurological Disorders and Stroke as a priority for epilepsy research, “and we hope our research will increase awareness of comorbidities.”

Disclosures: Study sponsored by Ortho-McNeil Janssen Scientific Affairs. Dr. Ottman reported no conflicts of interest.

BOSTON — Certain central nervous system-related comorbidities occur more often among people with self-reported epilepsy than in the general population, according to a large survey of U.S. households.

Individuals who reported ever having had epilepsy or a seizure disorder were more likely than those without a self-reported epilepsy diagnosis to have ever had depression, anxiety, bipolar disorder, attention-deficit/hyperactivity disorder, sleep disorder, or migraine, Ruth Ottman, Ph.D., reported at the annual meeting of the American Epilepsy Society.

Dr. Ottman, professor of epidemiology and neurology at Columbia University, New York, and her colleagues developed an 11-item screening survey that was mailed in 2008 to 340,000 households from two national panels selected to be representative of the U.S. population.

Of the 3,488 people who reported having ever had epilepsy or a seizure disorder, 61% were female, the mean age was 48 years, 35% had a seizure or convulsion within the previous 12 months, and 27% reported having had a febrile seizure or convulsion as a child. In the epilepsy cohort, 33% reported ever having depression, compared with 26% of controls without epilepsy. The epilepsy cohort was more likely to report a history of anxiety disorder (22% vs. 14%), bipolar disorder (14% vs. 7%), and ADHD (13% vs. 6%). The epilepsy cohort also was more likely to report sleep disorder (20% vs. 14%) and migraine (28% vs. 21%).

The survey did not collect information on specific medications, but “it is possible that some of the comorbidity in our study could be related to medications,” Dr. Ottman said in an interview. “However, for several of the comorbid disorders we described, other studies have found significantly increased occurrences even before the first seizure, suggesting that medications do not explain all of the comorbidity.” For example, “the prevalence of depression is higher in people with epilepsy than in people without it, even before the first seizure occurs, and this is also true for migraine.”

A possible explanation for the increased prevalence of certain CNS comorbidities might be a “shared pathogenic mechanism underlying epilepsy and the other disorders, possibly due to shared genetic susceptibilities or to common environmental risk factors,” Dr. Ottman said.

Clinicians should be aware of the potential for CNS-related comorbidities so they can consider medications effective in treating both epilepsy and certain comorbid disorders, she said. Comorbidities have been highlighted by the National Institute of Neurological Disorders and Stroke as a priority for epilepsy research, “and we hope our research will increase awareness of comorbidities.”

Disclosures: Study sponsored by Ortho-McNeil Janssen Scientific Affairs. Dr. Ottman reported no conflicts of interest.