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Non‐pharmacological interventions for epilepsy in people with intellectual disabilities

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Abstract

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Background

Approximately 30% of epilepsy patients remain refractory to drug treatment and continue to experience seizures whilst taking one or more antiepileptic drugs. There are a number of non‐pharmacological interventions available to refractory patients, which may be used in conjunction with or as an alternative to antiepileptic medication. In view of the fact that seizures in intellectually disabled people are often complex and refractory to pharmacological interventions it is evident that good quality randomised controlled trials (RCTs) assessing the efficacy of alternatives or adjuncts to pharmacological interventions are needed in this population.

This is an updated version of the original Cochrane Review published in The Cochrane Library 2007, Issue 4.

Objectives

The aim of our study was to assess the data available from randomised controlled trials of non‐pharmacological interventions in patients with epilepsy and intellectual disabilities.

Search methods

We searched the Cochrane Epilepsy Group Specialised Register (16 December 2010), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 4), MEDLINE (Ovid, 1950 to November week 3, 2010), PsycINFO (1806 to December 2010) and the National Research Register (2000 to December 2009).

Selection criteria

Randomised controlled trials of non‐pharmacological interventions for people with epilepsy and intellectual disabilities.

Data collection and analysis

Two review authors independently applied the inclusion criteria and extracted data.

Main results

No studies are included in this review. The updated search in December 2010 identified one RCT in progress, but there were no other studies meeting the criteria for this study population.

Authors' conclusions

This review has highlighted the need for well‐designed randomised controlled trials to assess the effect of non‐pharmacological interventions on seizure and behavioural outcomes in an intellectually disabled epilepsy population.

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Plain language summary

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Non‐pharmacological interventions for epilepsy in people with intellectual disabilities

This review identified the lack of any randomised controlled trials (RCTs) for non‐pharmacological interventions in people with epilepsy and intellectual disabilities. There is evidently a need for well‐designed RCTs to ascertain the effects of non‐pharmacological interventions on seizure and behavioural outcomes in this population. However, good quality RCT evidence in the non‐intellectually disabled should be assessed for the side effect and efficacy profile prior before undertaking such studies.