COGNITIVE ASSESSMENT IN A SAMPLE OF EGYPTIAN PATIENTS WITH GENERALIZED ONSET EPILEPSY

Abstract

Background: Cognitive brain functions constitute the ability to work with information in a meaningful way, apply gained information, perform preferential changes, and someone ability to change opinions about that information. Individuals with epilepsy have a higher prevalence of impaired cognitive performance compared to healthy individuals who are matched for age and education. Numerous factors can have a deleterious impact on cognition in patients, including age at onset of epilepsy, seizure frequency, duration of seizures, structural cerebral damage as a consequence of repetitive or prolonged seizures and medications used for treating seizures. Objective: Assessing the cognitive functions in patients with generalized onset epilepsy. Patients and Methods: Our study was conducted, in the neurology department of Sohag general hospital upon 75 individuals divided into 3 equal groups presented with epilepsy selected from the inpatient and outpatient clinics. Patients were divided into three groups: I. Group A: patients diagnosed with generalized onset epilepsy with medication (anti-epileptic drugs). II. Group B: patients diagnosed with generalized onset epilepsy without medication (anti-epileptic drugs). III. Group C: healthy subjects will be included in the study as the control group. All of the participants were be subjected to the following: *Full history (demographic data and personal history, detailed history of general health condition and chronic or current diseases) and general and neurological examination *Special tests including: PEBL Wisconsin (Berg) Card Sort test, PEBL The Conners’ continuous performance test, Montreal cognitive assessment (MoCa) *Brain imaging: MRI brain (to exclude organic cause). *EEG. Results: The mean Correct Responses Wisconison card sorting test of study groups was around 76.7±5.65 in group 1, around 78±2.88 in group 2 and 81.8±2.38 in group 3; with significant difference between group 1 and group 3 and significant difference between group 2 and group 3. The mean Target Acc Rate continuous performance test was around 0.956±0.03 in group 1, around 0.970±0.015 in group 2 and 0.974±0.015 in group 3; with significant difference between group 1 and group 2 and significant difference between group 1 and group 3. The mean MoCa of study groups was around 24.1 in epileptic with medication group, 23.96 in epileptic without medication group and 25 in control group with no significant difference between all groups. With high significant difference between Group 1 versus Group 3, and Group 2 versus Group 3. The normal MoCa was around 3 in epileptic with medication group, 2 in epileptic without medication group and 22 in control group with high significant difference between all groups. Conclusion: All patients with epilepsy reported significant impairment in all cognitive measures such as working memory, inhibitory control, goal maintenance, and mental flexibility. We observed attentional deficits in processes such as alertness and attention span and those requiring sustained and divided attention compared with controls. Attentional and executive impairment was correlated with higher frequency of seizures.