Cognitive and Affective Disorders in Patients with Epilepsy

Abstract

Objectives Conducted acomprehensive examination of 112 patients of both sexes, with an established diagnosis of epilepsy, seizure focus, duration of the disease not more than 10 years, who have cognitive and affective disorders. Aims In the research with the aim to study the cognitive and affectivedisorders in patients with epilepsy and to develop principles for correction andrehabilitation of patients. Methods Cognitive function in patients with epilepsy were evaluatedaccording to the Mini–mental state examination scale (MMSE). Results We systematized affective disorder inpatients by etiopathogenic factor: psychogenic, combined, medications (due tothe influence of anticonvulsants) and nosogenic (provoked by the disease). Themain types of clinical variants of non-psychotic affective disorders inpatients with epilepsy in the interictal period were indicated: depressivedisorders, affective reactions, dysphoria and obsessive-phobic disorders. At the initial examination before the study in all patients cognitivedisturbances were established (MMSE): 20,5 ± 2,5 point. These indicators ofcognitive productivity can be classified as “mild dementia “ (20-23points). Anintegrated approach was consists of methods of pharmacotherapy, psychotherapy,and psychoeducational training. Patients received Lamotrigine (the traditionalscheme was used), as well as complex psychotherapeutic methods of influence:rational psychotherapy, family psychotherapy, cognitive training, andpsychoeducational sociotherapy programs. Conclusions The study demonstrated that this rehabilitation programbased on the clinically differentiated approach is the main prerequisite foreffective social and employment recovery of epilepsy patients with cognitive andaffective disorders.