Epilepsy: Complications

The following are the most important diseases or complications that may be contributed to by epilepsy:

Psyche – Nervous System (F00-F99; G00-G99).

  • ADHD (attention-deficit/hyperactivity disorder) – in children with epilepsy.
  • Anxiety disorders
  • Dementia – Those who develop epilepsy in old age are at increased risk for dementia; epilepsy also accelerates dementia.
  • Depression
  • Insomnia (sleep disturbance; prevalence/illness: 36-74.4%).
  • Psychosis
  • Status epilepticus – prolonged epileptic seizure that can be fatal.
  • Substance abuse
  • SUDEP (sudden unexpected death in epilepsy) – sudden unexplained death in epilepsy with no evidence of relevant trauma or drowning, with or without evidence of a previous epileptic seizure, but with no evidence of previous status epilepticus

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99)

  • Suicidality (suicide risk) (up to 10-fold higher than rates in the general population); suicidal intent could be demonstrated in a retrospective cohort study in epilepsy patients before diagnosis: first attempt at suicide 2.9 times higher than in controls, subsequent attempt was 1.8 times more common in future epilepsy patients.

Injuries, poisonings, and other consequences of external causes (S00-T98).

  • Drowning → swimming only under supervision
  • Fractures (broken bones)
  • Accidents (3-fold increased risk); 70% of the reasons for unnatural death.
  • Poisonings and overdoses – including drug poisoning (23% of reasons for unnatural death; 11% control group; about 10% antiepileptic drugs, >50% opioids)
  • Vertebral fractures
  • Wounds due to falls

Further

  • Complicated epilepsy in childhood: more often school problems, less often a driver’s license; uncomplicated epilepsy in childhood and after five years of remission: young adults show social outcomes comparable to sibling controls.
  • Mortality (death rate)
    • Almost 3 times higher than in a control group of nonepileptic patients (hazard ratio 2.97; 95% confidence interval 2.54-3.48)
    • 5.57-fold increased during pregnancy