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Cognitive function after status epilepticus versus after multiple generalized tonic-clonic seizures.

Kjersti N Power1, Arne Gramstad2, Nils Erik Gilhus1

  • 1Department of Neurology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine (K1), Section for Neurology, University of Bergen, Norway.

Epilepsy Research
|December 12, 2017
PubMed
Summary

Status epilepticus (SE) and multiple generalized tonic-clonic (GTC) seizures are linked to cognitive impairment, particularly in memory and learning. While SE patients showed poorer psychomotor speed initially, long-term effects between SE and GTC seizures on cognition remain unclear.

Keywords:
CANTABCognitionEpilepsyGeneralized tonic-clonic seizureOutcomeStatus epilepticus

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Area of Science:

  • Neurology
  • Neuroscience
  • Cognitive Science

Background:

  • Status epilepticus (SE) is a recognized risk factor for cognitive impairment.
  • Previous studies suggest SE may cause greater cognitive decline than multiple lifetime generalized tonic-clonic (GTC) seizures.

Purpose of the Study:

  • To investigate cognitive dysfunction in patients with SE versus those with multiple lifetime GTC seizures.
  • To determine if cognitive disabilities differ between these two patient groups.

Main Methods:

  • Patients with SE were assessed post-ictally and after one year.
  • Cognitive function was evaluated using the Cambridge Neuropsychological Test Automated Battery (CANTAB), including tests for psychomotor speed, memory, and executive function.
  • Results were compared to patients with ≥10 GTC seizures and control subjects, with adjustments for premorbid IQ and brain lesions.

Main Results:

  • Immediately after SE, patients exhibited poor performance across all cognitive domains.
  • Both SE patients (at follow-up) and those with multiple GTC seizures showed significant memory deficits compared to controls, even after adjustments.
  • While SE patients initially performed worse in psychomotor speed, this difference was not significant after covariate adjustments.

Conclusions:

  • The study could not definitively conclude if SE is a more significant risk factor for cognitive dysfunction than repeated GTC seizures.
  • Memory and learning impairments were persistent in both SE and GTC seizure patient groups after accounting for IQ and brain lesions.