Patients with epilepsy: cognitively compromised before the start of antiepileptic drug treatment?
OBJECTIVE
To compare the cognitive profile of newly diagnosed untreated epilepsy patients with healthy volunteers using a comprehensive neuropsychological test battery.


METHODS
A total of 155 untreated patients with newly diagnosed epilepsy, and no known brain pathology, were assessed before the start of treatment with antiepileptic medication. Their scores across the neuropsychological measures were compared with 87 healthy volunteers from the general population equated for age and sex.


RESULTS
After adjusting for age, sex, and education, patients with epilepsy performed significantly worse than healthy volunteers on 6 of 14 cognitive measures, particularly in the domains of memory and psychomotor speed. Cognitive performance was not related to the number of seizures, type of epilepsy, or mood. When an impairment index was calculated, 53.5% patients had a least one abnormal score [>2 standard deviations (SD) below the control mean] on the test battery compared with 20.7% of healthy volunteers.


CONCLUSIONS
Newly diagnosed untreated patients with epilepsy are cognitively compromised before the start of antiepileptic drug medication. The domains most affected are memory and psychomotor speed. More than one-half of the patients had at least one abnormal test score across the test battery. There were no differences in epilepsy-related or mood variables between those who demonstrated dysfunction and those that did not.
Taylor
Joanne
J
Division of Neurological Science, University of Liverpool, Liverpool, United Kingdom.
Kolamunnage-Dona
Ruwanthi
R
Marson
Anthony G
AG
Smith
Philip E M
PE
Aldenkamp
Albert P
AP
Baker
Gus A
GA
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology; D015897:Comorbidity; D004522:Educational Status; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011594:Psychometrics; D011597:Psychomotor Performance; D006113:United Kingdom / Q000453:epidemiology
D000927:Anticonvulsants