Excess mortality and hospitalized morbidity in newly treated epilepsy patients

Chen, Zhibin; Liew, Danny; Kwan, Patrick

doi:10.1212/wnl.0000000000002984

Cited by 63 publications

(61 citation statements)

References 30 publications

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“…Adult patients with drug‐resistant epilepsy in Hong Kong had worse verbal recall memory than those with drug‐responsive epilepsy, and there were correlations between psychological well‐being and cognitive performance . Data from the Taiwan National Health Insurance Research Database showed a bidirectional association between epilepsy and attention‐deficit/hyperactivity disorder (Table ) …”

Section: Burden Of Epilepsymentioning

confidence: 99%

“…A recent Hong Kong study found a standardized mortality ratio (SMR) of 5.09 among newly diagnosed patients with epilepsy . The SMR was higher among patients with baseline physical and/or psychiatric comorbidity and highest for those with both physical and psychiatric comorbidities (Table ) . Two studies from Taiwan found SMRs for patients with epilepsy of 2.5 and 3.47, with the age‐specific SMRs being highest for boys and young women .…”

Section: Burden Of Epilepsymentioning

confidence: 99%

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Epilepsy in Asia: Disease burden, management barriers, and challenges

et al. 2018

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This article reviews the burden of epilepsy in Asia, the challenges faced by people with epilepsy, and the management of epilepsy. Comparison is made with other parts of the world. For this narrative review, data were collected using specified search criteria. Articles investigating the epidemiology of epilepsy, diagnosis, comorbidities and associated mortality, stigmatization, and treatment were included. Epilepsy is a global health care issue affecting up to 70 million people worldwide. Nearly 80% of people with epilepsy live in low- and middle-income countries with limited resources. People with epilepsy are prone to physical and psychological comorbidities, including anxiety and depression, which can negatively impact their quality of life. Furthermore, people with epilepsy are at higher risk of premature death than people without epilepsy. Discrimination or stigmatization of people with epilepsy is common in Asia and can affect their education, work, and marriage opportunities. Access to epilepsy treatment varies throughout Asia. Although highly advanced treatment is available in some countries, up to 90% of people with epilepsy are not adequately treated or are not treated with conventional antiepileptic therapy in resource-limited countries. People in remote areas often do not receive any epilepsy care. First-generation antiepileptic drugs (AEDs) are available, but usually only in urban areas, and second-generation AEDs are not available in all countries. Newer AEDs tend to have more favorable safety profiles than first-generation AEDs and provide options to tailor therapy for individual patients, especially those with comorbidities. Active epilepsy surgery centers are present in some countries, although epilepsy surgery is often underutilized given the number of patients who could benefit. Further epidemiologic research is needed to provide accurate epilepsy data across the Asian region. Coordinated action is warranted to improve access to treatment and care.

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Section: Burden Of Epilepsymentioning

confidence: 99%

Section: Burden Of Epilepsymentioning

confidence: 99%

Epilepsy in Asia: Disease burden, management barriers, and challenges

et al. 2018

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“…In the general population, mortality in those with epilepsy is higher among persons with psychiatric and physical comorbidity (8), and the most common causes of death include cancer, cardiovascular disease, cerebrovascular disease, and pneumonia (9). Moreover, patients with persistent seizures and diagnoses of symptomatic or cryptogenic epilepsies § have the largest excess mortality (4).…”

Section: Discussionmentioning

confidence: 99%

Epilepsy Among Iraq and Afghanistan War Veterans — United States, 2002–2015

Pugh¹,

Cott²,

Amuan³

et al. 2016

MMWR Morb. Mortal. Wkly. Rep.

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“…Epilepsies are associated with a high social, psychological, and economic burden for patients, particularly in Asian countries, where the stigma of epilepsy remains high and discrimination against people with epilepsy is common . The risk of premature death among patients with epilepsy is approximately 2–3 times higher than that in the general population, but is up to 5 times greater in Asian cohorts . Premature death may be related to the underlying cause of the disease, comorbidities, accidents occurring during a seizure, status epilepticus, sudden unexplained death in epilepsy, or suicide…”

Section: Introductionmentioning

confidence: 99%