Cognitive prognosis in chronic temporal lobe epilepsy
- PMID: 16802302
- DOI: 10.1002/ana.20872
Cognitive prognosis in chronic temporal lobe epilepsy
Abstract
Objective: First, to determine whether patients with chronic temporal lobe epilepsy have a different cognitive trajectory compared to control subjects over a prospective 4-year interval; second, to determine the proportion of patients who exhibit abnormal cognitive change and their profile of demographic, clinical epilepsy, and baseline quantitative magnetic resonance imaging characteristics; and third, to determine the most vulnerable cognitive domains.
Methods: Participants with chronic temporal lobe epilepsy (n = 46) attending a tertiary referral clinic and healthy control subjects (n = 65) underwent neuropsychological assessment and reevaluation 4 years later. Analysis of test-retest patterns identified individual patients with adverse cognition outcomes.
Results: The prospective cognitive trajectory of patients with chronic temporal lobe epilepsy differs from age- and sex-matched healthy control subjects. Lack of practice effects is common, but frank adverse cognitive outcomes are observed in a subset of patients (20-25%), particularly in vulnerable cognitive domains that include memory. Cognitive declines are associated with a profile of abnormalities in baseline quantitative magnetic resonance volumetrics, lower baseline intellectual capacity, as well as longer duration of epilepsy and older chronological age.
Interpretation: Cognitive prognosis is poor for a subset of patients characterized by chronicity of epilepsy, older age, lower intellectual ability, and more baseline abnormalities in quantitative magnetic resonance volumetrics.
Comment in
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New evidence supports cognitive decline in temporal lobe epilepsy.Epilepsy Curr. 2007 Jan-Feb;7(1):12-4. doi: 10.1111/j.1535-7511.2007.00155.x. Epilepsy Curr. 2007. PMID: 17304345 Free PMC article. No abstract available.
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