Exploring Effects of Epilepsy on the Young and the Disadvantaged

Excess Death in Young Epilepsy Patients OFTEN Not Seizure Related

Most excess death in young people with epilepsy is not seizure-related, new research confirms. Although mortality is significantly higher compared with the general population in children with complicated epilepsy, it is not increased in uncomplicated epilepsy. In the analyzed population of 2,239 subjects from four pediatric epilepsy cohorts, 13 deaths were seizure-related (10 SUDEP, three other). This equated to 19 percent of all deaths.
—Pediatrics 2013 Epub

Similar findings emerged from a review of data from the Medical Diagnostic Index of the Rochester Epidemiology Project. While the analysis showed that mortality in children with epilepsy was higher than in the general pediatric population, it was most often linked to poorly controlled epilepsy or neurologic impairment. Epilepsy-related death, including SUDEP, was rare. The rate of mortality due to epilepsy alone was similar to the expected mortality in the general population with two observed deaths, compared to 1.77 predicted.
—Epilepsia. 2012 Dec;53(12):2164-71

Dietary Caffeine May Not Precipitate Seizures

Patients with epilepsy may not have to give up their daily java, research suggests. Although caffeine acts as a central nervous stimulant by blocking A1 and A2A adenosine receptors, it does not appear to precipitate seizures. Patients acutely hospitalized for seizures (n=174) were asked for their consumption of caffeinated beverages 24 hours prior to admission as well as their habitual caffeine intake. A subsequent telephone interview assessed caffeine consumption on a seizure-free day (n=154). There was no difference in caffeine consumption prior to the seizure and on a seizurefree day.
—Epilepsy Behav. 2013 Jun 5;28(2):147-150

Epilepsy Incidence and Prevalence

A new analysis suggests epilepsy may disproportionately affect Americans of poor health and/or low income. For example, incidence and prevalence of epilepsy are higher for:

• Men
• Older people
• Blacks
• People with preexisting disability and/or comorbid conditions.

The most common preexisting conditions in epilepsy subjects were:

• Depression
• Developmental disorders
• Stroke.

—Neurology. 80(21):1942-9.

Epilepsy Surgery Linked to Good Cognitive Outcomes

For a majority of children undergoing epilepsy surgery, longterm cognitive level is preserved, and most patients (76 percent) follow their expected cognitive trajectory, Swedish researchers found. They followed 47 patients who had surgery as children over the course of five to 21 years. Twentythree children achieved seizure freedom, six demonstrated greater than 75 percent improvement in seizure frequency, and none experienced an increase in seizure frequency. Twenty-one children required a reoperation to achieve satisfactory seizure outcomes. Patients who achieved seizure freedom significantly improved their cognitive processing speed, which was even more pronounced in subjects with no anti-epilepsy drugs.
—Acta Neurol Scand. Epub