TY - JOUR
T1 - Cognitive performances in patients affected by late-onset epilepsy with unknown etiology
T2 - A 12-month follow-up study
AU - Liguori, Claudio
AU - Costa, Cinzia
AU - Franchini, Flaminia
AU - Izzi, Francesca
AU - Spanetta, Matteo
AU - Cesarini, Elena Nardi
AU - Di Santo, Simona
AU - Manfredi, Natalia
AU - Farotti, Lucia
AU - Romoli, Michele
AU - Lanari, Alessandro
AU - Salvadori, Nicola
AU - Parnetti, Lucilla
AU - Calabresi, Paolo
AU - Mercuri, Nicola Biagio
AU - Placidi, Fabio
PY - 2019/12
Y1 - 2019/12
N2 - 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.
AB - 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.
KW - Antiepileptic drugs
KW - Cognition
KW - Late-onset epilepsy
KW - Seizures
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UR - http://www.scopus.com/inward/citedby.url?scp=85074572110&partnerID=8YFLogxK
U2 - 10.1016/j.yebeh.2019.106592
DO - 10.1016/j.yebeh.2019.106592
M3 - Article
AN - SCOPUS:85074572110
VL - 101
JO - Epilepsy and Behavior
JF - Epilepsy and Behavior
SN - 1525-5050
M1 - 106592
ER -