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

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 s...

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Published in:Epilepsy & behavior 2019-12, Vol.101 (Pt A), p.106592-106592, Article 106592
Main Authors: Liguori, Claudio, Costa, Cinzia, Franchini, Flaminia, Izzi, Francesca, Spanetta, Matteo, Cesarini, Elena Nardi, Di Santo, Simona, Manfredi, Natalia, Farotti, Lucia, Romoli, Michele, Lanari, Alessandro, Salvadori, Nicola, Parnetti, Lucilla, Calabresi, Paolo, Mercuri, Nicola Biagio, Placidi, Fabio
Format: Article
Language:English
Subjects:
Antiepileptic drugs
Cognition
Late-onset epilepsy
Seizures
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Summary: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. 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. 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. 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. •Evidence of cognitive decline in patients with LOEU is scarce and limited to small samples.•LOEU shows a particular susceptibility to cognitive decline.•VPA seems to negatively influence cognition in patients with LOEU.
ISSN:1525-5050
1525-5069
DOI:10.1016/j.yebeh.2019.106592