August 10, 2018
A recent study, published online in Psychogeriatrics, suggests that anti-epileptic drug (AED) treatment for older amnestic patients with temporal spikes improved cognitive decline and related electroencephalographic abnormalities.
Epilepsy is becoming increasingly more common among older adult patients. In these patients, epileptic seizures are mostly complex seizures without convulsions, so more caution is needed when diagnosing suggests the researchers of the study led by Kazumasa Shiozaki, MD, PhD, and Satoshi Kajihara, MD, PhD, of the Department of Psychiatry, Yokohama Comprehensive Care Continuum (Yokohama, Japan).
“If epileptic seizures in the context of memory impairment are overlooked, epilepsy may be misdiagnosed as dementia,” authors wrote. “However, in older patients with epilepsy, there is a possibility that cognitive function may be impaired in the interictal phase.”
In order to evaluate the effectiveness of AED treatment for patients with cognitive impairment and interictal epileptiform discharge (IED) on electroencephalography, the researchers conducted a retrospective study. They observed the outcomes of AED therapy in 50 patients who exhibited IED. The researchers assessed cognitive function using the Mini-Mental State Examinations (MMSE) at both baseline and after AED administration.
According to the findings, for patients who underwent electroencephalography, IED were temporal spikes, and re‐examination of the 50 patients revealed that the frequency of temporal spikes had decreased or else disappeared in 41 patients (82%) after AED administration. Of the 41 patients, the average MMSE score increased from 23.4 ± 3.7 at baseline to 24.7 ± 4.8 after AED treatment (P < .01). The average serial 7s score, the MMSE subscale, also improved from 2.5 ± 1.8 to 3.6 ± 1.6 (P < .01).
“The MMSE score was significantly improved only in the 41 patients with recovery of IED,” researchers concluded.
They also noted that a thorough search of IED is still needed among older amnesic patients due to a possibility that IED modifies cognitive function.
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