Abstracts

Rationale: forgetfulness is a common symptom in people with epilepsy (PWE). Many symptoms of neurologic or psychiatric illness-such as cognitive impairment, depression, anxiety, and attention deficits-occur more frequently in PWE than in the general population. The aim of the work was to assess subjective forgetfulness among PWE and its relation with epilepsy co morbidities Methods: PWE attending neurology outpatient clinic in Mansoura University Hospital, were recruited for the study after exclusion of patients with mental retardation and those below high school education & abnormal findings on brain magnetic resonance imaging. The prevalence of subjective forgetfulness was assessed with the question "Do you consider yourself as being forgetful?" Respondents who answered "yes" to this question also required clarifying if it affects their daily life. After detailed history of epilepsy-related variables, we assessed all subjects' cognitive function, attention, anxiety, and depression by well known, validated tests: Mini-mental status examination (MMSE), digit symbol test (DST) & trail making test (TMT), Hamilton's scale for anxiety and the neurological disorders depression inventory for epilepsy (NDDI-E) respectively. The study had been approved by the ethical committee of neurology department, Mansoura university and informed consent was signed by all patients before the study. Results: The study included 98 patients; and 30 subjects, matched in age and gender, served as controls. The mean age of the patient was 28.7 ±9.03. Their clinical characteristics are shown in table (1): Sodium Valproate was the most commonly used drug as monotherapy (31) or in combination (33), followed by carbamazepine; alone (13) and in combination (25). Compared to controls, PWE showed significant abnormality in all studied domains: Hamilton Scale for anxiety : (cases: 14.5 ± 4.9. controls: 4.2 ± 1.6.as (mean ±SD),with P <0.001*), NDDI-E for depression (the median for cases: 10 & Controls: 11 with P =0.07), MMSE (the median for cases: 27 & Controls: 30. P < 0.001*), DST in seconds (the median for cases 60 & for controls 80 with P < 0.001*), and TMT in seconds (the median for cases 40 & controls 60, with P < 0.001*). Patients with subjective forgetfulness were seen in 69.4% of patients. When compared to those who didn't report that symptom, though, they were older (29.7 ± 9.2 vs. 26.5± 8) and showed tendency to occur among patients using polytherapy (χ2=3 & P = 0.06) & had higher body mass index (27.16 ±3.2, vs. 24.6 ± 3.5), neither of them including the type of seizures and its frequency showed significant differences. Logistic regression analysis for the predictors of forgetfulness were performed and only anxiety was significant predictor of forgetfulness among studied epileptic patients with OR (95% CI) (4.4(1.3-15.2) as seen in table 2. Conclusions: cognitive and psychiatric disorders are among the common co-morbities of epilepsy. Subjective forgetfulness is a common problem among PWE and affects their daily life. Anxiety was the only significant predictor of subjective forgetfulness and needs to be addressed & managed in such patients