Therapy for neurobehavioral disorders in epilepsy.
Neurobehavioral disorders commonly affect patients with epilepsy. In addition to the behavioral changes during and immediately after seizures, the epileptogenic disorder of function often extends further into the postictal and interictal period. Cognitive impairments commonly affect attention, memory, mental speed, and language, as well as executive and social functions. Reducing seizure frequency and the antiepileptic drug burden can reduce these problems. Attentional deficits may respond to therapies for attention-deficit/hyperactivity disorder, but apart from patients with this comorbid disorder, their efficacy is unproven in other epilepsy patients. No effective therapies are established for other cognitive problems, but pragmatic, compensatory strategies can be helpful. Behavioral disorders include fatigue, depression, anxiety, and psychosis. Many of these disorders usually respond well to pharmacotherapy, which can be supplemented by psychotherapy. Cognitive and behavioral disorders can be the greatest cause of morbidity and impaired quality of life, often overshadowing seizures. Yet these problems often go unrecognized and, even when identified, are often undertreated or untreated.
Devinsky
Orrin
O
Departments of Neurology, Neurosurgery, and Psychiatry New York University School of Medicine, New York, New York, USA. od4@nyu.edu
D000927:Anticonvulsants / Q000493:pharmacokinetics / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000188:drug therapy* / Q000453:epidemiology; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology; D011619:Psychotropic Drugs / Q000493:pharmacokinetics / Q000627:therapeutic use*
D000927:Anticonvulsants; D011619:Psychotropic Drugs