Expert opinion on diagnosis and management of epilepsy-associated comorbidities
Peltola et al. 2023
Presented by Dr. Pyae Phyo Aung
3:31 - Expert Opinions on Epilepsy and Comorbidities: Discussion of the impact of epilepsy on cardiovascular and psychological health, stressing the importance of managing comorbidities to enhance quality of life.
5:29 - Sleep Disorders and Epilepsy: The bidirectional relationship between sleep disorders and epilepsy was emphasized, with a focus on history-taking and various management strategies.
14:03 - Cognitive Dysfunction in Epilepsy: Cognitive impairment is common in newly diagnosed epilepsy patients, with multifactorial causes and strategies for diagnosis and management discussed.
16:24 - Depression in Epilepsy: Depression is prevalent in epilepsy, with a bidirectional relationship with seizures, necessitating recognition and management to improve quality of life and reduce suicide risk.
Discussion
0:30 - Management of Comorbidities in Epilepsy: Clinicians should prioritize comorbidity management in epilepsy by using pre-clinic questionnaires to assess cardiovascular and psychiatric symptoms efficiently.
2:38 - Seizure Control and Comorbidities: Participants concluded that managing severe comorbidities might aid in seizure control due to the bidirectional links with conditions like depression and sleep disorders.
4:10 - Cardiovascular Screening in Epilepsy Patients: ECGs and cardiovascular symptom monitoring are recommended for epilepsy patients, with a personalized approach based on individual risk factors.
7:10 - Psychogenic Non-Epileptic Seizures: Functional seizures, distinct from epileptic ones, are managed with psychotherapy as they lack epileptic brain discharges.
8:34 - Managing Depression in Epilepsy Patients: For suicidal epilepsy patients with severe depression, mood stabilizers and SSRIs are recommended, avoiding drugs that worsen depression, supported by official guidelines.
Integrated care for mental health in epilepsy: A systematic review and meta-synthesis by the International League Against Epilepsy Integrated Mental Health Care Pathways Task Force
Gandy et al. 2025
Presented by Dr. Irina Oane
1:35 - Integrated Mental Health Care in Epilepsy: A review emphasized the need for mental health care in epilepsy due to resource limitations, lack of standardized procedures, and unclear responsibilities for comorbidities.
6:58 - Screening and Evaluation: The review found that 48% of articles included mental health professionals in teams, and 66% screened for depression and anxiety, with 14% conducting comprehensive psychiatric evaluations.
8:39 - Screening Uptake and Locations: Mental health screening had a 74% uptake among eligible patients, conducted in epilepsy monitoring units, inpatient services, and during neuropsychological assessments and pre-surgical evaluations.
10:12 - Referral and Interventions: Identified mental health issues led to referrals to social work and psychology, with 35% using non-pharmacological interventions and 9% prescribing medications.
11:59 - Barriers and Facilitators: Barriers and facilitators included staffing, workflows, personalized care, electronic tools, with institutional support and language translation noted as obstacles.
Discussion
0:35 - Barriers and Enablers in Integrated Care: Participants highlighted the need for easy and infrequent screening for mental health comorbidities, noting that many patients don't recognize their mental health issues, impacting their quality of life.
3:58 - Psychoeducation for Patients with Dual Seizures: Psychoeducation can help patients with both epileptic and functional seizures by reducing feelings of lack of control through clear explanations and reassurance.
8:37 - Screening for Mental Health in Intellectual Disability Patients: Mental health screening in patients with intellectual disabilities is conducted through caregivers, who can identify and report issues due to their special connection.
10:05 - Comprehensive Care in Resource-Limited Settings: In resource-limited settings, the panel suggested using questionnaires and forming networks with tertiary care consultants for integrated patient care.
11:55 - Alternative Treatments for Epilepsy: The panel agreed that alternative treatments are acceptable if they do not harm or negatively interact with medications, as they can provide psychological support.