Few treatments exist for the cognitive impairments

Few treatments exist for the cognitive impairments associated with MS. Epilepsy Up to 50% of patients with epilepsy43 have psychiatric syndromes. Cognitive, mood, anxiety, and psychotic disturbances are most common. Since the epilepsies are heterogeneous and chronic conditions, this complexity is also reflected in the associated psychiatric disturbances. Epileptic syndromes are now classified using a disease approach according to seizure type, including both focal and generalized epilepsies. For the most part, psychiatric disturbances have been categorized according to whether they are direct expressions of a seizure, features of Inhibitors,research,lifescience,medical a postictal state, or phenomena that occur during the interictal

period. While this classification makes intuitive sense and is important

because at least some psychiatric phenomena are in fact direct consequences of having a seizure, it runs the risk of taking the focus away from the damaged brain and putting it on the occurrence of the seizures. Inhibitors,research,lifescience,medical The majority of psychiatric syndromes in epilepsy occur in the selleck chemical interictal period, and thus probably have more to do with the state of the brain in the absence of excessive electrical discharge than with the discharge itself. Cognitive dysfunction in epilepsy is manifested through mental slowness, memory dysfunction, and attentional problems in 30% Inhibitors,research,lifescience,medical to 50% of patients. If the age of onset of epilepsy is in childhood, learning disability and language deficits may develop because of the effects of the primary disease on brain maturation. The causes of cognitive dysfunction in

epilepsy patients are complex and include the Erlotinib supplier underlying brain disease, the effects of chronic repetitive seizures on the functioning Inhibitors,research,lifescience,medical of the brain, and the short-term Inhibitors,research,lifescience,medical and long-term effects of antiepileptic drug treatments. Depressive disturbances are the most common psychiatric condition seen in patients with epilepsy, but tend to be underdetected and undertreated despite their significant effects on patients. Up to 50% may develop major depression, although population-based studies report much lower rates of lifetime depression in patients with epilepsy of the order of 6% to 30%. 44 Depression rates are higher in patients who are surgical candidates for epilepsy treatment. The clinical presentation of depressive disturbances is for the most part typical for idiopathic depression. Anacetrapib However, about a third of patients with epilepsy present with atypical features of depression that tend to be intermittent. They also resemble dysthymia and include anhedonia, fatigue, anxiety, and irritability with less prominent impairments in self-attitude, self-depreciative ideas, or suicidal ideation. However, overall, suicide rates are four times higher in patients with epilepsy and 25 times higher in patients with temporal lobe epilepsy than the general population.

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