title: Why do seizures occur when they do? Situations perceived to be associated with increased or decreased seizure likelihood in people with epilepsy and intellectual disability.
abstract: Seizure precipitants are commonly reported in the general population of people with epilepsy. However, there has been little research in this area in people with epilepsy and intellectual disability (ID). We conducted a survey of the situations associated with increased or decreased seizure likelihood in this population. The aim of the research was to identify situations of increased seizure likelihood (SISLs) and situations of decreased seizure likelihood (SDSLs) reported by carers of people with an ID and epilepsy. Three study groups were investigated: two groups comprising individuals with ID associated with a specific genetic diagnosis - Rett syndrome or fragile X syndrome - and one group consisting of individuals with a range of other etiologies. Responses relating to 100 people were received: 44 relating to people with Rett syndrome, 25 to people with fragile X syndrome, and 31 to people whose ID had some other etiologies. Ninety-eight percent of the respondents reported at least one SISL, and 60% reported at least one SDSL. Having more seizure types and greater seizure frequency were associated with a higher number of SISLs reported. The most commonly reported SISLs and SDSLs for each of the three groups are presented. The most common SISL overall was illness, which was reported as an SISL by 71% of the respondents. There was less consensus with regard to SDSLs. These findings provide a greater understanding of when seizures occur in those with ID and epilepsy, with possible implications for adjunctive behavioral management of seizures in those with treatment-refractory epilepsy.
authors.affiliation: Department of Psychiatry, University of Cambridge, Douglas House, 18d Trumpington Road, Cambridge CB2 8AH, UK. Electronic address: jo.illingworth@cantab.net.
authors.forename: Josephine L
authors.initials: JL
authors.lastname: Illingworth
authors.affiliation: Medical Research Council Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 7EF, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Watson
authors.affiliation: Department of Psychiatry, University of Cambridge, Douglas House, 18d Trumpington Road, Cambridge CB2 8AH, UK; Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK; NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) East of England, Cambridge, UK.
authors.forename: Howard
authors.initials: H
authors.lastname: Ring
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D015897:Comorbidity; D004827:Epilepsy / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D011336:Probability; D012640:Seizures / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
keywords: Epilepsy; Genetic syndrome; Inhibiting factor; Intellectual disability; Seizure precipitant; Survey