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Published:22 July 2013

Call for more holistic treatment of epilepsy

Leading neurologist Professor Ley Sander is  calling for a new 'mantra' in the management of epilepsy following research published in The Lancet today. The research shows that people  who have epilepsy  and  associated  psychiatric conditions such as depression are at the greatest risk of dying prematurely .

The 41-year study of almost 70,000 patients with epilepsy found that three quarters of those who died from accidents or suicide had also been diagnosed with a psychiatric condition during their lifetime.

Professor Sander, medical director at Epilepsy Society, said: ' "Is it really epilepsy?" has long been a mantra in the management of epilepsy, since misdiagnosis is common. Perhaps we need to introduce another mantra: "epilepsy and what else?" as this holistic approach could help with the treatment of epilepsy and address the issue of reduced life expectancy.'

Increased mortality and epilepsy

Professor Sander commented that although previous studies had shown that people with epilepsy died earlier than the general population, this was the first study that 'convincingly showed' that co-existing common psychiatric illnesses were 'major culprits for increased mortality'.

The latest study from the University of Oxford, looked at almost 70,000 people with epilepsy born in Sweden between 1954 and 2009.

In the follow up around 9 per cent of people with epilepsy had died compared with 0.7 per cent of people in the general population.  The majority of early deaths from external causes were from suicides - and people with epilepsy and substance misuse were 22 times more likely to die from external causes than those with neither condition.

Professor Sander said:  'The potential effect of substance misuse, which seems more common in people with epilepsy, is interesting and perhaps we should also be screening people with epilepsy more robustly for substance misuse, particularly if this would lead to changed outcomes with decreased premature mortality.'