Co-morbidities in people living with epilepsy: hospital based case-control study from a resource-poor setting

Evaluating co-morbidity in people living with epilepsy (PWE) is essential and its modification might improve their quality of life. We analyzed the various co-morbidities in PWE in comparison with the normal healthy controls.

This prospective study was conducted from July 2006 to December 2007. PWE attending neurology outpatient services (n=250) with age ranging from 16 to 60 years (29.66+/-11.31 years; M:F 116:134) were recruited after obtaining informed consent. Healthy matched controls (n=250; 30.35+/-11.05 years; M:F 114:136) were also recruited.

The seizure types were: generalized (62.4%), complex-partial (21.6%), simple-partial (8.8%), and unclassified (7.2%). Sixty-nine percent were on monotherapy, and rest required polytherapy, with 90.8% on adequate dosages of anti-convulsants. About 83.2% were compliant and 70.4% had satisfactory control of seizures. At least 1 co-morbid condition was noted in 152 (60.8%) cases and among them, 62 (24.8%) had > or =2 co-morbidities. Control population was also evaluated for the presence of same co-morbidities and compared with cases. The various significant co-morbidities included: migraine (cases: 25.6% vs. controls: 15.2%; p=0.02), anxiety (cases: 2.4% vs. controls: 0%; p=0.04), depression (case: 5.2% vs. controls: 0.4%; p=0.0009), sleep disturbances (case: 6.8% vs. controls: 0.4%; p=0.0002), neurocysticercosis (cases: 15.6% vs. controls: 0%; p=<0.001), pulmonary tuberculosis (cases: 3.6% vs. controls: 0%; p=0.002) and extra-pulmonary tuberculosis (cases: 2.8% vs. controls: 0.4%; p=0.03). Less common co-morbidities were hypertension, diabetes, osteoarthritis, asthma, hypothyroidism, and acid-peptic disease.

In people living with epilepsy attending neurology OPD services, co-morbid illnesses were commonly observed compared to healthy controls.