Erfassung kognitiver Defizite bei Patienten mit Intelligenzminderung und Epilepsie

Abstract

Epilepsies are common in patients with intellectual disabilities, especially when the disabilities are severe or profound. Epilepsy centres therefore often have to take care of patients with intellectual disabilities or mental retardation. The feasibility of neuropsychological examinations in this field is limited since instruments are poorly standardised and validated for this group of patients with 2 or more standard deviations below mean in normal distribution. Nevertheless, in patients with epilepsy and intellectual disability there are some situations where neuropsychological testing is essential. These include the classification of mild mental retardation for assessment of autonomy in patients, the monitoring of adverse effects when antiepileptic drugs are increased or replaced, preoperative neuropsychological diagnostics, or the question of the additional development of dementia. Due to the fact that the available neuropsychological instruments often fail to answer the addressed question in patients with intellectual disabilities, additional alternative methods have to be applied to measure behavioural change or to categorise the level of skills achieved. One important possibility is to assess the social adaptation in a given environment. Scales measuring adaptive behaviour also provide an approximate indication of the degree of intellectual disability. The present paper presents and discusses possible neuropsychological instruments and rating scales to answer the above-mentioned questions.