Cognitive Impairment in People with Epilepsy.

Ajda Novak,Martin Rakusa,Karmen Vizjak

doi:10.3390/jcm11010267

Ajda Novak, Martin Rakusa + Show 1 more

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https://doi.org/10.3390/jcm11010267

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Abstract

People with epilepsy frequently have cognitive impairment. The majority of cognitive problems is influenced by a variety of interlinked factors, including the early onset of epilepsy and the frequency, intensity and duration of seizures, along with the anti-epileptic drug treatment. With a systematic review, we investigate significant factors about the cognitive impairment in epilepsy. Most cognitive problems in adult people with epilepsy include memory, attention and executive function deficits. However, which cognitive area is mainly affected highly depends on the location of epileptic activity. Moreover, modifications in signalling pathways and neuronal networks have an essential role in both the pathophysiology of epilepsy and in the mechanism responsible for cognitive impairment. Additionally, studies have shown that the use of polytherapy in the treatment of epilepsy with anti-epileptic drugs (AEDs) heightens the risk for cognitive impairment. It can be challenging to distinguish the contribution of each factor, because they are often closely intertwined.

Highlights

The International League Against Epilepsy (ILAE) defines epilepsy as a disease of the brain characterized by any of the following conditions: at least two unprovoked seizures occurring >24 h apart; one unprovoked seizure and a probability of further seizures similar to the general recurrence risk after two unprovoked seizures, occurring over the 10 years; diagnosis of an epilepsy syndrome [1,2]
Based on the selected search strategy and defined criteria, eight studies related to the mechanism of cognitive impairment in epilepsy, three studies on the effect of epileptic activity on cognitive impairment, six studies on the effect of anti-epileptic drugs (AEDs) on cognitive impairment, four studies on the association between psychosocial factors and cognitive impairment in epilepsy and nine studies directly related to the testing of cognitive functions in People with epilepsy (PWE) were included (Table 1)
The results showed that the overall cognitive function in PWE, when using the Montreal Cognitive Assessment (MoCA) and Clinical memory scale, was lower than a certain reference range and this indicates that the tests were sensitive even to mild memory impairment

Summary

Introduction

The International League Against Epilepsy (ILAE) defines epilepsy as a disease of the brain characterized by any of the following conditions: at least two unprovoked (or reflex) seizures occurring >24 h apart; one unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60 %) after two unprovoked seizures, occurring over the 10 years; diagnosis of an epilepsy syndrome [1,2]. Epileptic seizures are the result of the abnormal functioning of voltage-gated and transmitter-gated ion channels, which can make neurons electrically hyperactive. They can be classified as seizures with focal, generalized, or unknown onset [4]. There are several types of epileptic seizures, which can present as either minor or dramatic, short or long, frequent or rare. They can range from a major generalized tonic–clonic seizure to a mild myoclonic flickering of the eyelids or a focal numbness of the thumb and mouth [5]. The common symptoms are fatigue, headache, speech problems, abnormal behaviour and impaired concentration and memory, which disappear over time [6]

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