Individuals with intellectual disability and complex epilepsy: a case study of diagnostic overshadowing.

People with intellectual disability have a higher prevalence of epilepsy, care complexity, comorbidity and polypharmacy than the general population. These patients are often found to be on multiple medications without a clear rationale for ongoing prescriptions. Recent evidence has highlighted the o...

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Publicado en:British Journal of Nursing Vol. 35; no. 16; pp. 818 - 826
Autores principales: Boyle, Andrew, Spassiani, Natasha, Houghton, Valerie, Paterson, Ruth
Formato: case study tables/charts Journal Article
Publicado: Mark Allen Holdings Limited 9/3/2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 9/3/2026
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      pub: Mark Allen Holdings Limited
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        10.12968/bjon.2025.0427
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        atl: Individuals with intellectual disability and complex epilepsy: a case study of diagnostic overshadowing.
      aug:
        au:
          Boyle, Andrew
          Spassiani, Natasha
          Houghton, Valerie
          Paterson, Ruth
        affil: Lecturer, Edinburgh Napier University, Edinburgh, UK
      sug:
        subj:
          Intellectual Disability Drug Therapy
          Persons with Disabilities
          Lennox-Gastaut Syndrome Drug Therapy
          Polypharmacy
          Medication Management
          Seizures Etiology
          Iatrogenic Disease Prevention and Control
          Drug Interactions
          Anticonvulsants Administration and Dosage
          Anticonvulsants Blood
          Deprescribing
          Nursing Role
          Patient Advocacy
          Multidisciplinary Care Team
          Collaboration
      ab: People with intellectual disability have a higher prevalence of epilepsy, care complexity, comorbidity and polypharmacy than the general population. These patients are often found to be on multiple medications without a clear rationale for ongoing prescriptions. Recent evidence has highlighted the ongoing exposure to avoidable health inequalities and premature death in this population group, in which medicines management can play an influential role. This article aims to identify practical interventions to mitigate the risk of diagnostic overshadowing and health inequalities in individuals with intellectual disability and complex epilepsy. The discussion centres on a comprehensive retrospective analysis of the care outcomes experienced by an individual with a diagnosed epilepsy syndrome (Lennox-Gastaut syndrome). Rationalising medication is complex but can reduce the risk of drug interactions and adverse outcomes. Iatrogenic effects can be mistaken for physical health symptoms and confound care pathways. Systematic assessment and collaboration with appropriately experienced clinicians improves outcomes. Prospective therapeutic drug monitoring may have a role to play in mitigating adverse outcomes and diagnostic overshadowing in individuals with intellectual disability and complex epilepsy.
      pubtype: Academic Journal
      doctype:
        case study
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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