Overweight and eating disorders in people with epilepsy

Background: Epilepsy is a common neurological disease and occurs in 0.7-1.3 % of the general population. It is associated with comorbid mental disorders such as depression and anxiety, and with a high risk for adverse outcome during pregnancy and delivery. Epilepsy affects people of all ages, but especially among young people it represents a challenge in how to cope with the disease. This makes young people with epilepsy a vulnerable group. Aims: We hypothesized that young people with epilepsy have more eating disorders than the general population, and wanted to determine the prevalence of eating disorders among young people with epilepsy. A particular focus was put on pregnant women with epilepsy (WWE). We also wanted to investigate how comorbid eating disorders influence outcome of pregnancies in WWE. A second hypothesis we investigated was that young people with epilepsy are more overweight, and that such overweight leads to an increased risk for an adverse pregnancy-outcome in WWE. Material and methods: We used the Norwegian Mother and Child Cohort Study (MoBa) to study pregnancies in WWE. More than 100.000 women were included in this cohort, whereas 706 women reported a diagnosis of epilepsy. We compared pregnancies in women with and without epilepsy in relation to eating disorders and overweight, and also pregnancy-outcome. MoBa is linked to the Norwegian Medical Birth Registry (MBRN). Secondly we used the Health Profile for Children and Youth in Akershus Study to study prevalence of eating disorders among youth with epilepsy of both genders. We investigated also additional variables such as overweight, diet and physical activity. Results: We found that WWE have an increased rate of binge eating disorder compared to women without epilepsy. WWE were also more overweight and obese than the general population. Both of these variables were associated with adverse outcome during pregnancy and delivery in WWE. Young people with epilepsy in Akershus were more likely to have had contact with health personnel due to eating disorders than the referent. Conclusion: Pregnancies in WWE have a higher risk of adverse outcome. An increased rate of overweight and weight inducing eating disorders are contributing factors to this. The increased rate of eating disorders among people with epilepsy is evident from an early age, and this is important for health personnel to be aware of in their interaction with these patients. Early diagnosis and treatment is of great importance

Young people with epilepsy have an increased risk of eating disorder and poor quality diet

Objective: To investigate whether adolescents with epilepsy are at increased risk of having self‐reported eating disorder symptoms and poor quality diet compared to young people from the general population. Methods: We used data from the Health Profile for Children and Youth in Akershus Study, a cross‐sectional population‐based study based on a voluntary self‐reported questionnaire. There were 19,995 participants (response rate 85%) aged 13–19 years; 247 (1.2%) reported a lifetime diagnosis of epilepsy. Odds ratios (OR) and 95% confidence intervals (CI) for eating disorders, unhealthy diet, dieting, satisfaction with looks, and participation in sports were estimated by using a logistic regression model. All estimates were adjusted for single parents and poor family economy. Results: Children and adolescents with epilepsy had more eating disorders than their peers (OR 1.8, CI 1.0–3.0, p = 0.03). They were less satisfied with their own appearance (OR 0.7, CI 0.5–0.9, p = 0.02), and they eat more unhealthily (OR 1.7, CI 1.3–2.2, p = 0.001). Males with epilepsy were more likely to have been dieting (OR 3.1, CI 1.2–7.9, p = 0.02) and less satisfied with their own appearance (OR 0.4, CI 0.3–0.7, p < 0.001). Females with epilepsy were more likely to eat unhealthily (OR 1.7, CI 1.1–2.5, p = 0.01). Significance: Adolescents with epilepsy are at increased risk of having eating disorder symptoms. They eat less healthily and are less satisfied with their looks. Health workers should be aware of this and bring diet and lifestyle into the dialogue with young people with epilepsy.publishedVersio

Overweight and eating disorders in people with epilepsy

Background: Epilepsy is a common neurological disease and occurs in 0.7-1.3 % of the general population. It is associated with comorbid mental disorders such as depression and anxiety, and with a high risk for adverse outcome during pregnancy and delivery. Epilepsy affects people of all ages, but especially among young people it represents a challenge in how to cope with the disease. This makes young people with epilepsy a vulnerable group. Aims: We hypothesized that young people with epilepsy have more eating disorders than the general population, and wanted to determine the prevalence of eating disorders among young people with epilepsy. A particular focus was put on pregnant women with epilepsy (WWE). We also wanted to investigate how comorbid eating disorders influence outcome of pregnancies in WWE. A second hypothesis we investigated was that young people with epilepsy are more overweight, and that such overweight leads to an increased risk for an adverse pregnancy-outcome in WWE. Material and methods: We used the Norwegian Mother and Child Cohort Study (MoBa) to study pregnancies in WWE. More than 100.000 women were included in this cohort, whereas 706 women reported a diagnosis of epilepsy. We compared pregnancies in women with and without epilepsy in relation to eating disorders and overweight, and also pregnancy-outcome. MoBa is linked to the Norwegian Medical Birth Registry (MBRN). Secondly we used the Health Profile for Children and Youth in Akershus Study to study prevalence of eating disorders among youth with epilepsy of both genders. We investigated also additional variables such as overweight, diet and physical activity. Results: We found that WWE have an increased rate of binge eating disorder compared to women without epilepsy. WWE were also more overweight and obese than the general population. Both of these variables were associated with adverse outcome during pregnancy and delivery in WWE. Young people with epilepsy in Akershus were more likely to have had contact with health personnel due to eating disorders than the referent. Conclusion: Pregnancies in WWE have a higher risk of adverse outcome. An increased rate of overweight and weight inducing eating disorders are contributing factors to this. The increased rate of eating disorders among people with epilepsy is evident from an early age, and this is important for health personnel to be aware of in their interaction with these patients. Early diagnosis and treatment is of great importance

Idiopathic ventral spinal cord herniation - an increasingly recognized cause of thoracic myelopathy

Idiopathic spinal cord herniation (ISCH), where a segment of the spinal cord has herniated through a ventral defect in the dura, is a rarely encountered cause of thoracic myelopathy. The purpose of our study was to increase the clinical awareness of this condition by presenting our experience with seven consecutive cases treated in our department since 2005. All the patients developed pronounced spastic paraparesis or Brown-Séquard syndrome for several years (mean, 4.7 years) prior to diagnosis. MRI was consistent with a transdural spinal cord herniation in the mid-thoracic region in all the cases. The patients underwent surgical reduction of the herniated spinal cord and closure of the dural defect using an artificial dural patch. At follow-up, three patients experienced considerable clinical improvement, one had slight improvement, one had transient improvement, and two were unchanged. Two of the four patients with sphincter dysfunction regained sphincter control. MRI showed realignment of the spinal cord in all the patients. ISCH is probably a more common cause of thoracic myelopathy than previously recognized. The patients usually develop progressive myelopathy for several years before the correct diagnosis is made. Early diagnosis is important in order to treat the patients before the myelopathy has become advanced

Care in Europe after presenting to the emergency department with a seizure; position paper and insights from the European Audit of Seizure Management in Hospitals

info:eu-repo/semantics/publishe