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5 September 2013

Epilepsy experts call for more joined up thinking

Epilepsy experts have underlined the need for more collaborative research and better communication between medical services in order to improve the diagnosis and treatment of epilepsy. Professor Ley Sander, medical director at Epilepsy Society, told the International League Against Epilepsy (ILAE) in Glasgow, that epileptologists were on the verge of a conceptual breakthrough in their understanding of the causes of epilepsy.

However he warned that only an international effort would accelerate progress and achieve significant results for people with epilepsy.

‘We are now at the stage of seeing that a tendency for epilepsy seizures is always a genetic condition but that it is not always inherited,’ he told delegates. ‘Seizures may be a result of epigenetics, or changes in gene functions that do not affect a person’s underlying  DNA.

‘Once we understand epigenetic changes, we will start to make real progress. But we need a big international collaboration if we are to unravel the complexity of the many genetic mutations that cause the epilepsies – we need studies across the world involving thousands and thousands of people.’

Professor Sander also highlighted the need for a more holistic approach to epilepsy where it was seen as a condition of the body as well as of the brain.

‘Fifty per cent of people with chronic epilepsy also have other co-morbidities including vascular disease, cancer, dementia, obstructive sleep apnoea and injuries and fractures. We must treat epilepsy alongside these conditions.’

Anxiety and depression

Professor Niraj Agrawal from South West London and St George’s Trust emphasised the importance of  recognising the prevalence of anxiety and depression among people with epilepsy, and the need for joined up treatment.

‘People with anxiety and depression often feel stigmatised by it and may not want to report it to their GP or consultant,’ he told ILAE. ‘We need to develop tools to routinely diagnose these problems without relying on patients to self report.’

Epilepsy and sleep

Health experts also highlighted the high prevalence of sleep disorders as an often under estimated side effect of epilepsy.

Dr Ian Morrison from Ninewells Hospital, Dundee, told the conference: ’Sleep disorders are far more common among people with epilepsy that in the general population. Seizures can be triggered both by sleep and sleep deprivation.

‘Day time seizures can disrupt sleep as much as nocturnal seizures, so too can some of the medications prescribed. Sleep is a big problem f or people with epilepsy and can affect quality of life.’