Epilepsy, Fibromalgia (and CFS?) the co allied disorders

Cort

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We usually think of allied disorders as being fibromyalgia, TMJ, IBS, GWS but what about disorders that suggest 'seizure' or CNS overactivation such as epilepsy. Does that fit in with CFS?

Perhaps...they didn't look for CFS but they did look for FM and they found it. People with epilepsy were more likely to report they had been diagnosed with a wide variety of disorders including FM, chronic pain, migraine, ADHD, anxiety, depression, asthma (asthma?).

Of course the depression and anxiety are probably expected to be higher than normal because they had a chronic illness but the ADHD, FM, migraine are interesting since all of these may be increased in CFS as well.

Epilepsia. 2011 Jan 26. doi: 10.1111/j.1528-1167.2010.02927.x. [Epub ahead of print]
Comorbidities of epilepsy: Results from the Epilepsy Comorbidities and Health (EPIC) Survey.
Ottman R, Lipton RB, Ettinger AB, Cramer JA, Reed ML, Morrison A, Wan GJ.


Purpose:  To estimate the prevalence of neuropsychiatric and pain disorders in adults with epilepsy in the United States. Methods:  In 2008, an 11-item survey including validated questions to screen for a lifetime history of epilepsy was mailed to 340,000 households from two national panels selected to be generally representative of the noninstitutionalized U.S. population. Information on epilepsy and other disorders was collected from 172,959 respondents aged 18 or older. Propensity scoring was used to match respondents with and without epilepsy on baseline characteristics and risk factors for epilepsy. Prevalence ratios (PRs) of comorbidities in respondents with epilepsy were calculated using log-binomial generalized linear models.

Comorbidities were categorized as neuropsychiatric (anxiety, depression, bipolar disorder, attention-deficit/hyperactivity disorder, sleep disorder/apnea, and movement disorder/tremor), pain (migraine headache, chronic pain, fibromyalgia, neuropathic pain), and other (asthma, diabetes, and high blood pressure).

Key Findings:  Respondents with self-reported epilepsy were more likely (p < 0.001) than those without epilepsy to report all six neuropsychiatric disorders (PR from 1.27-2.39), all four pain disorders (PR 1.36-1.96), and asthma (PR 1.25).

Significance:  Neuropsychiatric conditions and pain disorder comorbidities were reported more often in individuals with self-reported epilepsy than in those without epilepsy. Identification of these conditions is an important consideration in the clinical management of epilepsy.

Wiley Periodicals, Inc. 2011 International League Against Epilepsy.
PMID: 21269285 [PubMed - as supplied by publisher]
 

Cort

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Migraine, Pain and CFS

Migraine is another disorder that suggests some sort of 'spasm' or overexcitation could be happening and allodynia - sensitivity to touch - is often found in FM. This study found that migraines sufferers who had allodynia tended to be diagnosed with CFS-like disorders (CFS, FM, IBS).....

The CFS-FM-Epileptic-Migraine group is intriguing. Could what disorder you get depend on where your blood vessels are effected? Or where the ANS goes out of whack (effecting the blood vessels?). I know someone who has gastrointestinal spasms. I have heard of people with esophageal spasms. Personally I think my muscles are kind of in a mild spasm.....

Its all conjecture - maybe wild conjecture - but what the heck

Headache. 2009 Oct;49(9):1333-44.
Allodynia in migraine: association with comorbid pain conditions.
Tietjen GE, Brandes JL, Peterlin BL, Eloff A, Dafer RM, Stein MR, Drexler E, Martin VT,

BACKGROUND: Cutaneous allodynia (CA) in migraine is a clinical manifestation of central nervous system sensitization. Several chronic pain syndromes and mood disorders are comorbid with migraine. In this study we examine the relationship of migraine-associated CA with these comorbid conditions. We also evaluate the association of CA with factors such as demographic profiles, migraine characteristics, and smoking status that may have an influence on the relationships of CA to pain and mood.

METHODS: Data are from a cross-sectional multicenter study of comorbid conditions in persons seeking treatment in headache clinics. Diagnosis of migraine was determined by a physician based on the International Classification of Headache Disorders-II criteria. Participants completed a self-administered questionnaire ascertaining sociodemographics, migraine-associated allodynia, physician-diagnosed comorbid medical and psychiatric disorders, headache-related disability, current depression, and anxiety.

RESULTS: A total of 1413 migraineurs (mean age = 42 years, 89% women) from 11 different headache treatment centers completed a survey on the prevalence of comorbid conditions. Aura was reported by 38% and chronic headache by 35% of the participants. Sixty percent of the study population reported at least one migraine-related allodynic symptom, 10% reported > or =4 symptoms.

Symptoms of CA were associated with female gender, body mass index, current smoking, presence of aura, chronic headaches, transformed headaches, severe headache-related disability, and duration of migraine illness from onset.

The prevalence of self-reported physician diagnosis of comorbid pain conditions (irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia) and psychiatric conditions (current depression and anxiety) was also associated with symptoms of CA.

Adjusted ordinal regression indicated a significant association between number of pain conditions and severity of CA (based on symptom count). Adjusting for sociodemographics, migraine characteristics, and current depression and anxiety, the likelihood of reporting symptoms of severe allodynia was much higher in those with 3 or more pain conditions (odds ratio = 3.03, 95% confidence interval: 1.78-5.17), and 2 pain conditions (odds ratio = 2.67, 95% confidence interval: 1.78-4.01) when compared with those with no comorbid pain condition.

CONCLUSION: Symptoms of CA in migraine were associated with current anxiety, depression, and several chronic pain conditions. A graded relationship was observed between number of allodynic symptoms and the number of pain conditions, even after adjusting for confounding factors. This study also presents the novel association of CA symptoms with younger age of migraine onset, and with cigarette smoking, in addition to confirming several previously reported findings.
 

WillowJ

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I have long thought migraine with aura was related to ME (and also to seizure), so this is really interesting. Extrapolating from migraine, I can see how epilepsy could be related to ME. Also, some of those with severe ME are said to have seizures.

Funny that Raynaud's isn't on that list.

The asthma I find fascinating... does it have a vascular component at all?
 

Enid

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No scientist here and much appreciating conjecture (we have to) - migraine (but much stronger) epileptic type "fits" (controlled by the epileptic drug Gabapentin) and muscle spasms (body shook), and heart for no apparent reason "leaping" were all part of my own grizzly picture. So this is most interesting Cort.