Can Even Well-Controlled Epilepsy Affect Life Outcomes?

Woman looking outside windowControlling the symptoms of epilepsy improves life outcomes, but young adults diagnosed with epilepsy during childhood may face educational, legal, and social difficulties, even when their seizures are controlled well, according to a study published in Pediatrics.

Epilepsy, which causes seizures, is the fourth most common neurological issue, affecting between 1.3 and 2.8 million people in the United States. About 7.1 out of every 1,000 people have the condition. Although epilepsy is not curable, treatments such as anti-seizure medications and surgery can significantly reduce symptoms.

Epilepsy Treatment Effectiveness

To find out how epilepsy affects children as they grow into adults, researchers followed 241 children diagnosed with the condition between 1993 and 1997, tracking each participant for an average of 12 years. Each child was treated at one of several Connecticut neurology practices. Researchers gathered data on treatment protocols and outcomes, educational and employment histories, marital status, criminal records, driving histories, and living arrangements.

After treatment began, the team divided children into several groups based on the effectiveness of treatment. Those with an “excellent” outcome had no seizures after the first year of treatment, showing complete remission at the end of the study. Ninety-five participants (39%) received this assessment.

A “good” outcome indicated some seizures one to five years after diagnosis, but complete remission at the end of the study. Fifty-six participants (23%) had this outcome. A “fluctuating” outcome indicated fluctuations in treatment effectiveness, accounting for 70 participants (29%). Participants in the “pharmacoresistant” group showed little progress with treatment. Twenty participants (8%) were labeled pharmacoresistant.

How Epilepsy Diagnosis and Treatment Affect Life Outcomes

Children for whom medication lessened or eliminated seizures had better overall life outcomes. Ninety percent of children with “excellent” seizure control were either in college or working full- or part-time, compared with 60% of the groups with less effective seizure control.

Seizure control, however, was not the only predictor of life outcomes. People with epilepsy who also had learning difficulties were almost 50% more likely to be unemployed. Emotional and mental health challenges such as depression and attention-deficit hyperactivity (ADHD) reduced the chances of completing college by 60% and decreased the chances of independent living by 50%.

All participants faced an equal risk of legal issues, regardless of how well-controlled their seizures were. However, those with a history of behavioral diagnoses such as oppositional defiance (ODD) were almost three times as likely to encounter legal difficulties.

The study’s authors highlight the need for increased counseling and transition planning for children and young adults diagnosed with epilepsy, particularly when the diagnosis accompanies other diagnoses or risk factors.

References:

  1. Berg, A. T., Baca, C. B., Rychlik, K., Vickrey, B. G., Caplan, R., Testa, F. M., & Levy, S. R. (2016). Determinants of social outcomes in adults with childhood-onset epilepsy. Pediatrics, 137(4). doi:10.1542/peds.2015-3944
  2. Epilepsy Foundation. (2014, March). Epilepsy Statistics. Retrieved from http://www.epilepsy.com/learn/epilepsy-statistics
  3. Even controlled, epilepsy may still cause problems for kids. (2016, March 31). Retrieved from http://www.upi.com/Health_News/2016/03/31/Even-controlled-epilepsy-may-still-cause-problems-for-kids/4741459454867/

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  • scotty

    scotty

    April 5th, 2016 at 3:02 PM

    it can be hard to explain to new people that you meet what could happen, it’s almost embarrassing and keeps me from making new friends I think

  • Linda F

    Linda F

    April 5th, 2016 at 5:23 PM

    I am not all that sure I understand… if it is well controlled then why the power that it still has over one’s life? I know that it can cause serious disruptions and health problems when left untreated but if you have found the right combo of medicines and it seems to be under control with few or even no seizures, then I struggle with what kind of impact it still has. And I am only asking because I am interested, not belittling or anything like that.

  • Nik

    Nik

    April 9th, 2016 at 12:39 PM

    Even when it is controlled you never know when that next seizure might render you incapacitated, if you might hurt yourself or someone else in the process.

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