Epilepsy Management in Individuals with Intellectual Disabilities

Epilepsy affects a disproportionately high proportion of people with intellectual disabilities (ID), with estimates suggesting that up to one in four individuals with ID experience seizures. Management of epilepsy in this population demands a holistic approach that addresses cognitive limitations, communication barriers and elevated comorbidity burdens. Antiseizure medications (ASMs) remain the mainstay of treatment, yet choice of therapy must balance seizure control against behavioural side-effects and broader health risks. Multidisciplinary care teams involving neurologists, psychiatrists, specialised nurses and social care professionals are essential to tailor treatment plans, monitor polypharmacy and adapt interventions to individual needs. Emerging service models emphasise shared care pathways, closer integration of social support and enhanced training for carers to recognise and respond to seizures. Technological innovations, including out-of-hospital electroencephalography (EEG) monitoring and digital seizure diaries, show promise in improving diagnostic precision and long-term follow-up. Despite progress, persistent challenges include treatment-resistant epilepsy, premature mortality and under-representation in clinical trials, underscoring the need for research that is both inclusive and responsive to the specific needs of people with ID.

Research from Nature Portfolio

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Epilepsy Management in Individuals with Intellectual Disabilities publication trend

The graph below shows the total number of articles in epilepsy management in individuals with intellectual disabilities across all publications each year (not limited to Nature Index journals).

Technical terms

Epilepsy: Chronic neurological disorder defined by recurrent unprovoked seizures arising from abnormal brain electrical activity.

Intellectual disability (ID): Neurodevelopmental condition characterised by significant limitations in intellectual functioning and adaptive behaviour manifesting before adulthood.

Antiseizure medications (ASMs): Pharmacological agents aimed at preventing or reducing the frequency of epileptic seizures.

Polypharmacy: Concurrent use of multiple medications, increasing the risk of drug–drug interactions and adverse effects.

Electroencephalography (EEG): Technique for recording the brain’s electrical activity, used to characterise seizure type and guide treatment.

References

1. Under representation of people with epilepsy and intellectual disability in research. PLOS ONE (2018).
2. Tackling increased risks in older adults with intellectual disability and epilepsy: Data from a national multicentre cohort study. Seizure (2022).
3. At home EEG monitoring technologies for people with epilepsy and intellectual disabilities: A scoping review. Seizure (2023).
4. Patterns of antiseizure medications prescribing in people with intellectual disability and epilepsy: A narrative review and analysis. British Journal of Clinical Pharmacology (2023).