Keep your eyes open! Untreated co-morbidities in adults with epilepsy and learning disability
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Purpose: To determine the prevalence and nature of undiagnosed co-morbidities in new referrals to an epilepsy and learning disability service. Method: Our clinical database identified new referrals with epilepsy and learning disability over a 12 month period. Ninety-three adults were referred. Patients with any previous contact with the service were excluded. 62 met the inclusion criteria. All patients were assessed by a Consultant Nurse with expertise in epilepsy and learning disability and a Consultant Neurologist. Medical records were reviewed to compare diagnostic and co morbidity information provided at the point of referral with that following detailed assessment. Co morbidities were treated within our Service or through appropriate specialist referral (who confirmed comorbid diagnoses). Results: Previously undiagnosed and untreated co-morbidities were identified in 58% of newly referred patients. Twenty-four separate health conditions were identified, including sleep disorder, drug toxicity, helicobacter pylori, seborrhoeic dermatitis, hypertension, lymphoedema, allergic rhinitis, hypothyroidism, tremor, hearing impairment, cataract, and reflux. 23% were vitamin D deficient. Conclusion: We demonstrate the importance of a holistic approach to the assessment and treatment of patients with a learning disability presenting to an epilepsy clinic. A learning disability may mask co-morbid conditions. We recommend a proactive and comprehensive approach to assessment. We find an integrated Neurology and Learning Disability Service beneficial.