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Cited by 55Epilepsy research and treatmentPharmacological Effects and Toxicity StudiesDiet and metabolism studies

Comprehensive care of the epilepsy patient—control, comorbidity, and cost

W. Bazil, Carl·2004·Epilepsia
DOI 10.1111/j.0013-9580.2004.455002.x
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Abstract

Traditionally, control of seizures in patients with epilepsy is viewed as the most important clinical outcome. Yet, current antiepileptic drugs (AEDs) do not always achieve this. Around 30-40% of patients remain uncontrolled despite pharmacological intervention. Poor tolerability of AEDs is a large part of the problem and contributes as much to the overall effectiveness of therapy as efficacy. Comorbid conditions are present in many patients, and appropriate management of these can further improve seizure control and quality of life. Patients with epilepsy often experience--among other disorders--neuropsychological effects, migraines, and psychological problems (especially anxiety and depression). Sleep disturbances are also common and have been shown to contribute to the intractability of seizures in some patients. Many anticonvulsant treatments have the potential to improve--or in some cases worsen--these concurrent conditions, and these properties should therefore be considered in the total care of the patient. Finally, the costs of uncontrolled epilepsy are measured not only in terms of direct healthcare-related costs, but also in terms of lost productivity and opportunity. The indirect costs of epilepsy are substantial and account for 70-85% of total disease-related costs. Patients with uncontrolled seizures contribute disproportionately to healthcare costs, reinforcing the need for the development of newer AEDs with improved profiles of efficacy and tolerability, but with minimal adverse effects on behavior, cognition, and sleep.

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Crossref · 10.1111/j.0013-9580.2004.455002.x

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115 of 115 references verified0 citation errors · 0 not checkable

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  • The expression and manifestations of mental ill-health in people with epilepsy are inevitably affected by culture and social context and by the nature of epilepsy itself and the available treatments and care systems.

    “The expression and manifestations of mental ill-health in PWE are inevitably affected by culture and social context and by the nature of epilepsy itself and the available treatments and care systems [21, 22].”

    From Experience and perceptions of mental ill-health in people with epilepsy in rural Ethiopia: A qualitative study (2024) · cites this paper as [21]

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Authors
W. Bazil, C.
Venue
Epilepsia
Publisher
Wiley
Published
2004-08
Volume
45
Issue
s6
Pages
3-12
ISSN
  • 0013-9580 (ISSN-L)
  • 1528-1167
DOI
10.1111/j.0013-9580.2004.455002.x
OpenAlex
W2079918136
Cited by
55
References
115
Citations by year
2026: 1 · 2025: 1 · 2024: 6 · 2023: 3 · 2021: 1 · 2020: 4 · 2017: 2 · 2016: 1 · 2015: 2 · 2014: 2 · 2013: 3 · 2012: 5
FWCI
1.45
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 16 d)
Locations
  • Epilepsia (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmacological Effects and Toxicity Studies
  • Health Sciences › Medicine › Physiology › Diet and metabolism studies
Keywords
epilepsy, antiepileptic drugs, seizure control, drug tolerability, comorbidities, neuropsychological outcomes, migraine, anxiety, depression, sleep disorders, health care costs, indirect costs, productivity loss, comprehensive care
MeSH terms
Anticonvulsants, Mental Disorders, Comprehensive Health Care, Epilepsy, Female, Health Services, Health Status, Humans, Male, Quality of Life, Sleep, Sleep Wake Disorders, Comorbidity, Prevalence, Health Care Costs, Cost of Illness, Secondary Prevention

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