Co-morbidities in epilepsy, the impact on children’s lives

Childhood epilepsy is a very complex neurological condition: in addition to the most well-known seizures, numerous epidemiological studies have found that people with epilepsy have a higher incidence of physical and psychiatric disorders than the general population. In medical jargon, these are called co-morbidities, and they are fundamental to recognise and study because they deeply affect the quality of life and the development of children.

In this article, we will try to give a brief overview of the different types of co-morbidities of epilepsy and their impact on the lives of young patients, therefore analysing their consequences, treatment approaches and future prospects.

What is a co-morbidity?

The term co-morbidity refers to the presence of one or more disorders or diseases in conjunction with a primary disease. In the context of epilepsy, co-morbidities can include a wide range of cognitive and emotional disorders. Sleep disorders and depression are frequently encountered, making therapeutic management even more complex.

Behavioural and psychiatric disorders are common in children and often remain untreated or undiagnosed. These problems can occur before the first symptoms of childhood epilepsy start and persist even after the seizures disappear.

The main types of co-morbidities in childhood epilepsy

Epilepsy occurs in children, in 60% of cases, with neuropsychiatric co-morbidities such as delayed intellectual development. The most common of these disorders is ADHD, which occurs in 40% of cases with co-morbidities. Children with epilepsy and ADHD experience deficits in response inhibition, working memory and abstract concept formation, and have greater risks of school failure and development of an oppositional disorder. The symptoms of ADHD often mask or are confused with those of epilepsy, thus delaying diagnosis and treatment.

Cognitive and emotional co-morbidities

The currently available quality studies of co-morbidities in childhood are limited and inadequate. However, as far as epilepsy is concerned, the data collected are slightly more robust and confirm what we have said above, namely, a high incidence of certain psychiatric disorders. As we mentioned earlier, the most common cognitive co-morbidities are learning disabilities and intellectual disability. Children with epilepsy may experience significant difficulties in the learning process, which manifest in the form of short-term memory problems, concentration and planning skills. It is also worth remembering emotional co-morbidities, such as depression and anxiety, that significantly affect the well-being of children with this condition.

Knowing this data, it is therefore clear that there are several behavioural changes in children caused by epilepsy. It is therefore essential to carefully monitor small patients in order to prevent important consequences, thus ensuring timely intervention, which is essential for the harmonious and healthy development of the child.

Effects on children’s quality of life and development

The co-morbidities of epilepsy do not only affect the cognitive and emotional spheres, but also have a direct impact on the child’s quality of life and global development. Conditions such as psychogenic convulsions, somatic and psychiatric problems and sleep disorders can impair daily activities, school performance and social relationships. The consequences of childhood epilepsy are, therefore, to be evaluated carefully and precisely: the ultimate aim is always to guarantee the health of the child, their overall well-being and, above all, a path of healthy and balanced growth.

Pharmacological and non-pharmacological approaches

The management of co-morbidities in childhood epilepsy requires an integrated approach that includes both pharmacological and non-pharmacological treatments. Polypharmacotherapy in epilepsy, although necessary in many cases, has problems such as the risk of drug interactions and an increased incidence of side effects. For this reason, the therapeutic approach should be carefully monitored and tailored to the needs of the individual patient.

Among non-pharmacological treatments, support through behavioural and psychological therapies, which can help children better manage all the emotional and behavioural aspects of the disease, is very important. In addition, recent studies have highlighted the role of vitamin B6 in childhood epilepsy, especially in the case of drug-resistant epilepsy.

Future perspectives between research and new therapeutic opportunities

Scientific research continues to explore new therapeutic opportunities to improve the well-being of young patients. Specifically in the field of research and development, Cor.Con. International has received the support of the institutions through the project approved within the European Funds of the Emilia-Romagna Region – Por Erdf 2014-2020: thanks to the funds, a new supplement for childhood epilepsy will be developed to treat co-morbidities and side effects in epileptic subjects, thus supporting ongoing drug therapies and improving the quality of life of the child.

The goal of Cor.Con. International is to create new formulation of dietary supplements based on physiological modulators to alleviate all the symptoms associated with the paediatric disease. The clinical efficacy of the new supplement is being studied through collaboration with the IRCSS Giannina Gaslini and the University of Parma.

As we have seen, the different types of childhood epilepsy and co-morbidities need a multidisciplinary and personalised approach. However, with advances in research and the implementation of new therapies, there are promising prospects for a future in which children with epilepsy can live increasingly symptom-free.