Psychiatric and Medical Comorbidity and Quality of Life Outcomes in Childhood-Onset Epilepsy

Baca, Christine B.; Vickrey, Barbara G.; Caplan, Rochelle; Vassar, Stefanie D.; Berg, Anne T.

doi:10.1542/peds.2011-0245

Cited by 220 publications

(152 citation statements)

References 76 publications

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“…Migraineurs affected by focal epilepsies had a risk for cryptogenic epilepsy that was three times higher than that for idiopathic epilepsy. Recently, adolescents with any headache type were reported (Lateef et al 2012) to have significantly higher rates of epilepsy, as previously confirmed by Baca et al (2011), who found the comorbidity of migraine and epilepsy in 15 % of the children they studied. Interestingly, Colombo et al (2011), whose data confirmed previous findings (Sasmaz et al 2004) showing that almost 36 % of parents of children with headache are unaware of the headache, stressed that pediatric headache is still under-diagnosed and is not adequately considered as a health problem either by the medical community or in social settings: on the one hand, this indicates the extent to which headache is underestimated, on the other, it confirms that the clinical picture in co-morbid cases is dominated by the diagnosis of epilepsy.…”

Section: Epidemiological Issues: Beyond the Controversial Evidencesupporting

confidence: 62%

The Complex Relationship Between Epilepsy and Headache and the Concept of Ictal Epileptic Headache

Parisi

2014

Contemporary Clinical Neuroscience

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Key Points-Headache/migraine is often associated with epilepsy in children, as a pre-ictal, ictal, post-ictal or inter-ictal phenomenon.-Epidemiological aspects of the co-morbidity between epilepsy and headache are clearly different in children and adults.-Headache as a symptom, with migraine characteristics and/or tension-type headache characteristics, may be the only clinical ictal manifestation of an epileptic seizure: this condition is now classified as "ictal epileptic headache".-In particular, according to published criteria, the term "ictal epileptic headache" must be used in cases of a headache/migraine attack as the sole clinical ictal symptom of epileptic origin, confirmed by ictal-EEG recording and clinical-EEG responsiveness to intravenous antiepileptic drugs.-EEG is not recommended as a routine examination for children diagnosed with headache, but is mandatory and must be carried out promptly in cases of prolonged migraine/headache that does not respond to antimigraine drugs and in which epilepsy is suspected.-This is not a marginal question, because these possible, isolated, non-motor, ictal manifestations (i.e. ictal epileptic headache) should be taken into account before declaring an epileptic patient as "seizure free" so as to be able to suspend anticonvulsant therapy safely. SummaryThe possible link/comorbidity (causal or not causal) between epilepsy and headaches has been a topic of debate for over a hundred years, ever Since William Richard Gowers's time. In recent decades, new data have emerged in favor of a non-random relationship between these two entities. They are both characterized by transient attacks of altered brain function with a clinical, pathophysiological, genetic and therapeutic overlap, and may thus mimic each other. Indeed, the clinical distinction between headache and epilepsy may make the differential diagnosis a highly challenging task. Both are common and often co-morbid, with headache attacks in epilepsy being temporally related to the occurrence of epileptic seizures as a pre-ictal, ictal, post-ictal or inter-ictal event. Yet, they are both paroxysmal and chronic neurological disorders that share many clinical and epidemiological aspects, and they may both present with visual, cognitive, sensitive-sensorial and motor signs/symptoms; these neurophysiologicl phenomena arise from the cerebral cortex and are modulated by sub-cortical connections. Even from an epidemiological point of view, data in the literature regarding the co-morbidity between headache and epilepsy appear to be quite distinct in children. What makes this scenario even more variegated and complex are new data suggesting that a headache may, in some cases, even be the only ictal manifestation of an epileptic seizure. The latter condition, the so-called "ictal epileptic headache", is a new entity that has recently been cited in the new classification of headache disorders (ICHD-III), whose diagnostic criteria have very recently been defined and published. The data that have led, over the last decade, to the...

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Section: Epidemiological Issues: Beyond the Controversial Evidencesupporting

confidence: 62%

The Complex Relationship Between Epilepsy and Headache and the Concept of Ictal Epileptic Headache

Parisi

2014

Contemporary Clinical Neuroscience

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“…The high proportions of medical disorders were a more surprising finding. Some of the specific medical diagnoses, such as asthma, have been investigated in other studies, 22,23 and found to be increased in CWE. However, few previous studies have assessed a broad range of medical disorders in CWE, so we will focus on this in the remainder of the discussion.…”

Section: Discussionmentioning

confidence: 93%

“…12 -21 Knowledge about other medical comorbidities is limited, and only a couple of studies have investigated this in children specifically. 22,23 Most studies of medical comorbidities have included only adults or subjects of all ages and primarily reported findings in adults. 24 -34 Some studies have focused on specific diagnoses rather than an extensive range.…”

mentioning

confidence: 99%

Comorbidity and Childhood Epilepsy: A Nationwide Registry Study

et al. 2016

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BACKGROUND AND OBJECTIVE: Children with epilepsy are at increased risk of other disorders and difficulties, preceding, cooccurring with, or after the diagnosis of epilepsy. Risk estimates vary, few studies are population-based, and few provide comprehensive assessments of comorbidities. We used nationwide registry data to describe frequencies of medical, neurologic, developmental, and psychiatric conditions occurring before and after children are diagnosed with childhood epilepsy.

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“…19,20 Psychiatric disorders were analyzed in groups for externalizing disorders (attention-deficit/hyperactivity, conduct, and oppositional-defiant) and internalizing disorders (depression, anxiety, obsessivecompulsive, and bipolar). Learning problems, including developmental delay, language problems, and dyslexia, were also grouped into a single dichotomous variable.…”

Section: Psychiatric and Learning Problemsmentioning

confidence: 99%

Determinants of Social Outcomes in Adults With Childhood-onset Epilepsy

et al. 2016

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Psychiatric and Medical Comorbidity and Quality of Life Outcomes in Childhood-Onset Epilepsy

Abstract: Psychiatric comorbidities are strongly associated with long-term HRQoL in childhood-onset epilepsy, which suggests that comprehensive epilepsy care must include screening and treatment for these conditions, even if seizures remit.

Cited by 220 publications

References 76 publications

The Complex Relationship Between Epilepsy and Headache and the Concept of Ictal Epileptic Headache

The Complex Relationship Between Epilepsy and Headache and the Concept of Ictal Epileptic Headache

Comorbidity and Childhood Epilepsy: A Nationwide Registry Study

Determinants of Social Outcomes in Adults With Childhood-onset Epilepsy

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