PHMR, Berkeley Works, London, UK.
NIHR University College London Hospitals Biomedical Research Centre, UCL Queen Square Institute of Neurology, London, UK.
Brain Behav. 2022 Sep;12(9):e2589. doi: 10.1002/brb3.2589. Epub 2022 Aug 26.
Epilepsy is one of the most common neurological conditions worldwide. As a chronic condition, epilepsy imposes a significant burden on people with epilepsy and society. We aimed to assess the burden and unmet need of individuals with epilepsy and their caregivers, focusing on focal seizures, the main type of seizure in adults and children.
A targeted evidence review of the burden of epilepsy, focusing on focal seizures, was conducted to identify articles reporting: epidemiology, mortality, morbidity, quality of life (QoL), and costs.
Focal seizures affect up to ∼61% of people with epilepsy. They are associated with an increased risk of injury and premature death than the general population. People with epilepsy also have high comorbidity, particularly depression, anxiety, and cognitive impairments. Higher seizure frequency, adverse treatment events, and employment concerns reduce QoL. A reduction in caregivers' QoL is also often reported. Epilepsy requires long-term treatment accounting for high individual costs. Hospitalizations and antiseizure medications (ASMs) are the leading cost drivers of inpatient management and indirect costs with high unemployment rates, particularly in drug-resistant populations. Despite the advent of new treatments, a high unmet need remains unaddressed; approximately 40% of people with epilepsy are drug-resistant, further increasing the risks associated with epilepsy.
Our findings highlight a substantial burden of illness and unmet needs in individuals with focal seizures, especially those with drug-resistant epilepsy. Suboptimal treatment options negatively impact QoL and, consequently, a sizeable economic burden indicating the need for new treatments and prioritizing this condition.
癫痫是全球最常见的神经系统疾病之一。作为一种慢性疾病，癫痫给癫痫患者及其照护者带来了巨大的负担。我们旨在评估癫痫患者及其照护者的负担和未满足的需求，重点关注成人和儿童中主要发作类型——局灶性发作。
我们对癫痫负担进行了有针对性的证据回顾，重点关注局灶性发作，以确定报告以下内容的文章：流行病学、死亡率、发病率、生活质量（QoL）和成本。
局灶性发作影响高达约 61%的癫痫患者。与一般人群相比，局灶性发作患者的受伤和过早死亡风险更高。癫痫患者还伴有高共病，尤其是抑郁、焦虑和认知障碍。较高的发作频率、不良治疗事件和就业问题会降低 QoL。照护者的 QoL 也经常受到影响。癫痫需要长期治疗，个人成本较高。住院和抗癫痫药物（ASM）是住院管理和间接成本的主要驱动因素，尤其是在药物抵抗人群中，失业率较高。尽管新治疗方法的出现，但仍存在大量未满足的需求；约 40%的癫痫患者对药物耐药，这进一步增加了癫痫相关风险。
我们的研究结果突显了局灶性发作患者存在大量疾病负担和未满足的需求，特别是那些患有耐药性癫痫的患者。治疗选择不理想会对 QoL 产生负面影响，进而带来巨大的经济负担，这表明需要新的治疗方法，并将这种疾病作为优先事项。
