Epilepsy in people with intellectual disability

It is well recognized that both Intellectual Disability (ID) and epilepsy individually have higher rates of premature mortality. Thus, the two conditions in combination will be more likely to lead to premature mortality than either individually. People with ID and epilepsy have a higher likelihood of communication, psychiatric, behavioural, and drug sensitivity problems that makes their treatment difficult. This is not a homogenous group. At one end of the spectrum are patients with mild ID, 10–12% of who have epilepsy and treatment is mainly focused on areas like compliance and risky behaviours. At the other end are patients with severe ID, up to 50% of who have epilepsy and treatment is more focused on factors such as the co-morbidity, impact of medications, recognition of side effects, treatment resistance, and informed consent. This chapter looks to collate and provide an overview of epilepsy diagnosis and management and the current good practice on its applicability to people with ID.