Should cognition be screened in new-onset epilepsies? A study in 247 untreated patients
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The aim of our study was to assess cognition in newly diagnosed and untreated patients with epilepsy in order to determine the prevalence and the determinants of cognitive deficits at this early stage of the disease. A total of 247 untreated patients with newly diagnosed epilepsy underwent a brief test battery focusing on attention and executive functions (EpiTrack®) and memory (short form of the VLMT). In addition, the assessment included ratings of self-perceived deficits in attention and memory. Impairments in attention and executive functions were seen in 49.4 % of the patients and memory deficits in 47.8 %. Unimpaired performance in both domains was observed in 27.9 % of the cases. Self-perceived deficits in attention were only reported by 28.7 % of the patients, and 25.1 % of the patients complained of memory impairments. Lower education and a symptomatic, i.e., lesional, cause of epilepsy were associated with worse performance in attention and executive functions, whereas worse memory performance was related to generalized tonic–clonic seizures. Results indicate a high prevalence of cognitive deficits at an early stage of epilepsy, which calls for consideration in the daily clinical care. Patients appear to underreport cognitive deficits. Thus, a routine application of a brief standardized neuropsychological screening before the initiation of a pharmacological treatment would be appreciated to provide a baseline to evaluate subsequent treatment success, to eventually initiate countermeasures, and to monitor the course of the disease.
KeywordsUntreated patients Newly diagnosed epilepsy Cognition Neuropsychology Screening
Conflicts of interest
The authors declare that they have no conflicts of interest.
- 4.Helmstaedter C, Hermann B, Lassonde M, Kahane P, Arzimanoglou A (eds) (2011) Neuropsychology in the care of people with epilepsy. Progress in Epileptic Disorders, vol 11. John Libbey Eurotext, MontrougeGoogle Scholar
- 12.Oostrom KJ, van Teeseling H, Smeets-Schouten A, Peters AC, Jennekens-Schinkel A (2005) Three to four years after diagnosis: cognition and behaviour in children with ‘epilepsy only’. A prospective, controlled study. Brain 128 (Pt 7):1546–1555. doi: 10.1093/brain/awh494
- 15.Helmstaedter C, Lutz M (2005) EpiTrack. Veränderungssensitives kognitives Screening zur Qualitäts- und Outcomekontrolle der Epilepsiebehandlung, UCB GmbHGoogle Scholar
- 18.Helmstaedter C, Lendt M, Lux S (2001) VLMT Verbaler Lern- und Merkfähigkeitstest. Beltz Test GmbH, GöttingenGoogle Scholar
- 21.Glanz BI, Holland CM, Gauthier SA, Amunwa EL, Liptak Z, Houtchens MK, Sperling RA, Khoury SJ, Guttmann CR, Weiner HL (2007) Cognitive dysfunction in patients with clinically isolated syndromes or newly diagnosed multiple sclerosis. Mult Scler 13(8):1004–1010. doi: 10.1177/1352458507077943 PubMedCrossRefGoogle Scholar