ASSOCIATION OF NEUROPSYCHOLOGICAL FINDINGS WITH CLINICAL OUTCOME IN NEWLY DIAGNOSED PARTIAL EPILEPSY
Abstract number :
2.161
Submission category :
Year :
2002
Submission ID :
1893
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Reetta Kalviainen, Sari Piiroinen, Tuuli Salmenpera, Asla Pitkanen, Marja Aikia. Department Of Neurology, Kuopio University Hospital and University of Kuopio, Kuopio, Finland; A.I.Virtanen Institute, University of Kuopio, Kuopio, Finland
RATIONALE: Cognitive disorders in people with epilepsy, particularly in chronic drug-resistant partial epilepsy, have long been recognized and documented. The purpose of the present study is to evaluate the neuropsychological performance of the patients at the time of the diagnosis of epilepsy, to perform a long-term follow-up of cognitive function in epilepsy and to identify surrogate markers for disease modification.
METHODS: Altogether 112 patients with newly diagnosed partial epilepsy were allocated to antiepileptic drug (AED) treatment with either a sodium channel-blocking agent (carbamazepine, N = 54) or with a GABAergic drug (tiagabine/vigabatrin, N = 40/18). Altogether 68 patients with only a single seizure and no AED treatment served as a control group. The patients and control were tested with comprehensive neuropsychological battery at baseline and after one-year follow-up.
RESULTS: More patients were initially seizure-free with carbamazepine than with a GABAergic drug. As a group the patients with either monotherapy showed no significant deterioration in verbal ability, memory performance, attention or reaction times as compared to baseline. However, practice effect at one-year reassessment was clearly shown in test scores of controls, but practice effect was less evident and slightly different in two AED groups. Part of the patients have already been through 2-3- and 5-follow-up assessments. A trend towards deterioration of neuropsychological performance in a subgroup of patients not achieving seizure-freedom was noticed, but no relationship to the type of initial treatment was found.
CONCLUSIONS: Present follow-up study of newly diagnosed epilepsy patients with either sodium channel-blocker or GABAergic AED treatment did show no decline in cognitive functioning. Practice effect was less evident than in controls which may be the first indicator of adverse AED effects. In the future most useful way for evaluating the course of epileptic process and effects of therapy might be combining several measures of outcome such as seizure-control, imaging data and neuropsychological data.
[Supported by: Kuopio University Hospital EVO-grant]; (Disclosure: Honoraria - Aventis, Novartis, Sanofi Synthelabo)