Epi-Life.com

	How common is it for people with learning disability to also have epilepsy?
	The frequency of epilepsy occurring in people with learning disability is higher than in the average population and increases in proportion to the severity of their disability. About 30% of people with a learning disability also have some form of epilepsy, however, in those people with a severe learning disability atleast 50% will have additional epilepsy.
	What is the link between learning disability and epilepsy?
	Both epilepsy and learning disability are outward symptoms of underlying brain dysfunction or damage. Generally, this damage has existed from birth. If the mother has an infection such as rubella or abuses drugs or alcohol, the developing brain of the baby may be damaged. Some learning disabilities are genetic such as Down's Syndrome or Tuberous Sclerosis. Head injuries from accidents, high fevers, brain infections or tumors can also cause brain damage.
	Treatment of these seizures is more difficult and they are often more severe, more frequent and harder to control.
	How can seizures be identified in someone with a learning disability?
	There are many types of seizure and some take the form of quite strange behavior sequences. Seizures may be particularly unusual in people with learning disability and can easily go unrecognised. This may be more likely in people who have poor communication skills.
	Any strange behaviour such as long periods of confusion or unusual physical activity may be the sign of a seizure. If any unusual behaviour occurs which you think might be a seizure, it is important to observe it closely and write down what you see. Many people with a learning disability show unusual behaviour which might not be a seizure but another sign of brain damage. Tests such as the EEG (if done whilst this activity is occurring) will determine whether or not this is seizure activity. Sometimes people will need special assessment to determine this.
	Can anti-epileptic medication cause behaviour problems?
	Anti-epileptic medication may make people feel drowsy or sick and it may affect their vision, but it seldom causes behaviour problems. The damaged brain is more vulnerable to the side- effects of anti-epileptic medication and obviously, if someone is not able to communicate what they are feeling this may result in withdrawn or sometimes aggressive behaviour. Sometimes, side- effects of medication such as slowing, inattention, restlessness, and unsteadiness when walking may be difficult to distinguish from the signs of underlying neurological disorder.
	How regularly should serum levels be tested?
	It is probably not good practise to rely heavily on drug levels for anti-epileptic drugs with maybe the exception of phenytoin. They provide a rough guide to dosing but should not be over- emphasised. The main reasons for checking blood levels are for testing drug compliance, to document overdoses and suspected drug interactions. They should be used when there is a clinical need rather than on a routine basis. The rules about testing serum levels should be the same for people with a learning disability as for anybody else.
	Can epilepsy impair cognitive functioning?
	Cognitive difficulties in individuals with learning disabilities are invariably due to the underlying brain damage which gives rise to the epilepsy. If the seizures are under optimal control, then further cognitive difficulties are unlikely. Seizures, however, if poorly controlled and particularly if undetected may result in additional impairments of cognitive function. Improvements may then occur if seizure control improves, although high levels of medications are to be avoided as this also would have a negative impact on mental alertness.
	Is neurosurgery an option for people with a learning disability?
	At one time, people with learning disabilities were not considered good candidates for surgical treatment of seizures. More recently, a more positive view is taken. However, as for individuals without learning disabilities, not everyone is suitable for surgery and each case requires close examination with careful consideration of the potential benefits and possible adverse effects of the surgery.