Health conditions that occur alongside epilepsy are called comorbidities. Epilepsy may increase a child and adolescent’s chances of having depression, anxiety, learning disorders, migraines and other health conditions. It is important to emphasize that in the majority of cases the comorbidities are not caused by the epilepsy, but rather they are the result of the underlying disorder causing the epilepsy. The chances of having a comorbidity depend on several factors, including the type of epilepsy, seizure frequency, medication and the response to treatment. It is important for physicians to detect and treat identified comorbid conditions early.
Children and youth with epilepsy (CYE) are at higher risk for developmental, intellectual and mental health comorbidities. According to the Neurobehavioral Comorbidities in Children with Active Epilepsy: A Population-based Study, 80% of CYE experienced cognitive impairment and/or at least one Diagnostic and Statistical Manual of Mental Disorders Text Revision (DSM) disorder. Common comorbidities associated with epilepsy include:
- Attention-deficit/Hyperactivity Disorder (ADHD)
- Learning Disabilities
- Mental Health Comorbidities: Depression, Anxiety, Autism Spectrum Disorder
Common Health Conditions Related to Epilepsy
- Attention Deficit Hyperactivity Disorder (ADHD) – There is a 20-50% prevalence rate of ADHD in children in youth with epilepsy (CYE), versus a 7-9% ADHD prevalence rate in the general population. CYE with ADHD often have additional mental health comorbidities such as oppositional defiant disorder, conduct disorder, learning disorders, depression, anxiety and autism spectrum disorders. For more information on ADHD, visit the HealthyChildren.org ADHD webpage.
- Autism Spectrum Disorders (ASD) – The prevalence of autism spectrum disorder (ASD) is increasing in the US. According to the AAP Clinical Report on Autism, there is both an increased risk for ASD among CYE and an increased risk for seizures in those with ASD. This risk for ASD among CYE is 6.3%. The National Institute of Neurological Disorders and Stroke found that about 20-30% of children and youth with ASD develop epilepsy by the time they reach adulthood. The connection between epilepsy and autism is still being studied. The current scientific view is that there are shared neurological mechanisms that contribute to both ASD and epilepsy. For more information on epilepsy and autism, visit the Autism Research Institute Autism and Seizure webpage.
- Depression – Depression is one of the most common comorbidities associated with epilepsy, affecting at least one quarter of CYE. Studies have shown that children with current reported epilepsy/seizure disorders were significantly more likely than those never diagnosed to experience depression (8% vs 2%). Research also indicates that CYE are at an increased risk for suicide compared to the general pediatric population. For more information on mental health and resources, visit the AAP Mental Health Initiatives webpage.
- Learning Challenges – Learning disabilities among children and youth with epilepsy (CYE) occur at a rate of approximately 32%, with the severity of the epilepsy correlating with the degree of learning impairment/learning disability. CYE with mild to moderate epilepsy are less likely to be affected with learning disabilities than those whose epilepsy is more severe. For most children with epilepsy and learning disabilities, there is an underlying disorder causing both the epilepsy and the learning disability (such a brain injury or a genetic disorder). For more information on learning challenges, please visit HealthyChildren.org.
- Mood disorders – Epilepsy can be both disruptive and traumatic for children or adolescents, it may affect daily activities (need to take medications, to have a rescue medication, etc.), and their identity. As a result, CYE are more likely to have mood disorders such as anxiety disorder, dysthymic disorder and bipolar disorder. It is important to acknowledge and address these disorders. For more information on epilepsy and mood disorders, visit the Epilepsy Foundation Moods and Behavior webpage.
- Other Concerns for Children and Youth with Epilepsy (CYE) – According to the National Profile of Childhood Epilepsy and Seizure Disorder, CYE may have difficulties beyond seizures, seizure medications and co-morbid conditions. They may be significantly less likely to receive care in a medical home, which leads to a higher risk of having unmet needs for care coordination, medical care and mental health services. Further, this disparity likely coincides with findings that children and youth from underrepresented racial and ethnic groups from racial and ethnic minorities, as well as lower income families, are disproportionately affected by epilepsy.
For more details, check out these helpful resources:
- AAP Clinical Report on Autism
- AAP Clinical Toolkit on Autism
- Epilepsy Foundation: Related Conditions
- Epilepsy Research UK: Conditions Related to Epilepsy
- Cleveland Clinic: Depression and Epilepsy in Children and Adolescents
American Academy of Pediatrics