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Understanding co-morbidities affecting children with epilepsy

From the Virginia Commonwealth University/Medical College of Virginia, Richmond, VA.

Address correspondence and reprint requests to Dr. John M. Pellock, Virginia Commonwealth University/Medical College of Virginia, 1001 E. Marshall St., Children’s Pavilion, 1st Floor, Richmond, VA 23298-0565.

Co-morbid conditions frequently occur in childhood epilepsy and may significantly affect epilepsy and its treatment. Similarly, epilepsy and antiepileptic drugs (AEDs) may affect these associated conditions. Co-morbidities that have a significant association with childhood epilepsy include attention-deficit/hyperactivity disorder, autism, developmental disabilities, accidental injury, migraine, and depression/anxiety. Understanding the interrelationships among co-morbidities, epilepsy, and their treatments is essential to optimal management of pediatric patients. Treatment should be individualized with consideration for specific co-morbidities and concomitant medications. Key treatment goals are to achieve seizure control and optimal physical and cognitive function using the simplest possible AED regimen. The clinician should consider whether an antiepileptic treatment can be chosen that also ameliorates the co-morbid condition. Newer AEDs, such as lamotrigine, topiramate, gabapentin, oxcarbazepine, and tiagabine, may benefit children with epilepsy and some co-morbid disorders.

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