Intellectual disability and epilepsy

Epilepsy in people with intellectual disability is more than the sum of the two conditions. Diagnosis is challenging in the face of cognitive and communication difficulties and in some instances the need to rely on third party information and difficulties in accessing relevant investigations. Treatment is complicated by the lack of evidence specific to intellectual disability and associated neurodevelopmental comorbidities. The presence in many with associated physical and psychological co-morbidity in the face of treatment resistance and increased preponderance to side effects and challenging behavior makes epilepsy management in people with intellectual disability highly complex. It can be argued that specific understanding and skill sets are needed to help manage this vulnerable group. This book chapter looks to outline the unique challenges and questions to treatment this special population poses and looks to provide evidence based up to date answers where available.