Cognitive disorders in epilepsy I: Clinical experience, real-world evidence and recommendations. (December 2020)

• Record Type: Journal Article
• Authors: Kanner, Andres M.; Helmstaedter, Christoph; Sadat-Hossieny, Zahra; Meador, Kimford
• Is Part Of: Seizure. Volume 83(2020)
• Page Start: 216
• Page End: 222
• Publication Date: 2020-12
• Subjects: Neuropsychology -- Epilepsy -- Cognition -- Epilepsy surgery -- Anticonvulsants; Epilepsy -- Periodicals; Epilepsy -- Periodicals; Seizures -- Periodicals; Épilepsie -- Périodiques; Electronic journals; Electronic journals; 616.853
• DOI: 10.1016/j.seizure.2020.10.009
• Languages: English
• ISSNs: 1059-1311

Abstract

Highlights: Cognitive disorders are a common comorbidity in children and adults with epilepsy. They are under-identified and frequently not treated. Cognitive disturbances may preceed the onset of seizures and are multifactorial. ADHD and depression are associated with a worse academic performance. The use of CNS stimulants and SSRI antidepressants are safe in patients with epilepsy. Abstract: This is the first of two narrative reviews on cognitive disorders in epilepsy (companion publication : Cognitive disorders in epilepsy II: Clinical targets, indications and selection of test instruments). Its focus is on clinical experience, real-world evidence, and clinical recommendations. Cognitive disorders are a common comorbidity in children and adults with epilepsy. These cognitive disturbances may preceed the onset of seizures and are multifactorial including contributions by pre-existing brain damage, seizures, interictal epileptic discharges, and treatments including medications and surgery. Comorbid cognitive impairments can have a negative impact on the quality of life in people with epilepsy. They are under-identified and frequently not treated. Comorbid psychiatric disorders, such as ADHD can also contribute to a worse cognitive performance and can benefit from pharmacotherapy with CNS stimulants. Likewise, mood disorders cause a subjective perception of poor memory and attention, which can be reversed with antidepressants of the SSRI family. This narrative review discusses these issues from a real-world clinical perspective in children and adults with newly diagnosed and chronic epilepsy. The need for further research to understand and treat these disorders is noted.