Cognitive performances in patients affected by late-onset epilepsy with unknown etiology: A 12-month follow-up study

Claudio Liguori, Cinzia Costa, Flaminia Franchini, Francesca Izzi, Matteo Spanetta, Elena Nardi Cesarini, Simona Di Santo, Natalia Manfredi, Lucia Farotti, Michele Romoli, Alessandro Lanari, Nicola Salvadori, Lucilla Parnetti, Paolo Calabresi, Nicola Biagio Mercuri, Fabio Placidi

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Epilepsy has a growing frequency, particularly in the elderly. Several triggers may cause late-onset epilepsy; however, more than 20% of epilepsies, manifesting in the elderly, has an unknown etiology. Although cognition is frequently altered in patients affected by epilepsy, there is a paucity of studies specifically evaluating cognition in patients affected by late-onset epilepsy. The aim of the present study was to assess the cognitive profile of patients affected by late-onset epilepsy with an unknown etiology and followed for 12 months. Methods: Patients affected by diagnosed late-onset epilepsy with unknown etiology were included in this observation. All patients were evaluated at the time of diagnosis (baseline) and at follow-up (12 months later). We distributed patients in subgroups based on seizure type (focal seizures [FS], secondarily generalized seizures [SGS], primarily generalized seizures [GS]) and antiepileptic drug (AED) regimen (mono- vs. polytherapy). Cognition was evaluated through standardized neuropsychological testing. Results: Fifty-eight patients were included in this observation and distributed in three groups: 29 affected by FS, 14 affected by SGS, 15 affected by GS. Forty-five patients were in monotherapy, and 13 in polytherapy. The most frequent treatments were levetiracetam (n = 12), valproic acid (VPA) (n = 9), carbamazepine (n = 9), and oxcarbazepine (n = 7). We documented a significant decrease of Mini-Mental State Examination (MMSE) and memory scores at follow-up in the whole group. Verbal learning decreased exclusively in VPA users. Conclusion: Patients affected by late-onset epilepsy with unknown etiology showed a significant decline of cognition at follow-up, independently from number and efficacy of AEDs received. These results deserve verification in larger longitudinal cohorts.

Original languageEnglish
Article number106592
JournalEpilepsy and Behavior
Volume101
DOIs
Publication statusPublished - Dec 2019

Keywords

  • Antiepileptic drugs
  • Cognition
  • Late-onset epilepsy
  • Seizures

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience

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