Behavioral Disorders in Epilepsy Patients with Intellectual Disability

The following five topics will be discussed. A) Prevalence: It is considered that 20-50% of individuals with intellectual disability (ID) show behavioral problems, while 30-40% of individuals affected by ID also have epilepsy. Thus, obviously, many epilepsy patients are also complicated with ID. B) Epilepsy-specific behavioral disorders in patients with ID and epilepsy: Previous findings are controversial and strong arguments have been provided, both those showing no difference between ID patients with and without epilepsy (Deb & Joyce 1999; Espie et al. 2003), and that the alleged association, if any, may actually be due to the contribution of autistic spectrum disorder (Smith & Matson 2010), as well as those showing lower rates of psycho-symptoms in this subgroup, possibly because of the psychotropic effects of AEDs (Arshad et al. 2011), with a 7-fold increase in the rate of behavioral disorders reported (Turkey et al. 2011). C) Standard medical treatment for behavioral problems in epilepsy patients with ID. It is challenging to establish a standard medical treatment regimen for this specific group. Although it is important to be well aware of related difficulties and lack of unanimously approved results, there are some helpful suggestions to be noted. Specifically, the following 2 questions will be discussed along with presentation of 4 relevant case vignettes.D) Is antipsychotic medication truly helpful to control disruptive behavior in epilepsy patients with ID E) Will discontinuation of benzodiazepines help to decrease behavioral problems in epilepsy patients with ID