The psychosocial impact of epilepsy in adults

Abstract

Although defined by the presence of recurrent seizures, epilepsy can be so much more and can include a very wide range of difficulties in cognition, psychiatric status, and social adaptive functioning. These psychosocial complications of epilepsy have a long history, generating calls for action by national commissions, public health agencies, and special action groups which are briefly summarized here. Next, a brief overview of the prevalence of psychosocial complications of epilepsy in population-based and other representative is presented. Finally, with a focus on the onset and development of psychosocial difficulties, the following points are stressed: (1) neurobiological factors likely contribute to psychosocial problems in a major way, but currently this contribution is poorly understood, and (2) although neurobiological factors may prove important, they operate in a social setting, and therefore, a full accounting of the etiology, treatment, and prevention of psychosocial problems in epilepsy will require an integrated biopsychosocial model and life span perspective.

Figure 1

Psychosocial issues of epilepsy (Lennox, 1960 [1])

Figure 2

The prevalence of bipolar symptoms in persons with epilepsy and other medical disorders and controls (Ettinger et al., 2005 [9]).

Figure 3

Patterns of cortical thinning in unilateral mesial temporal lobe epilepsy (Lin et al, 2007 [13]).

Figure 4

Degree of atrophy across diverse regions both ipsilateral and contralateral to side of temporal lobe seizure onset (Pulsipher et al., 2007 [15]).