EFFECT OF EPILEPSY, SEIZURES AND EPILEPTIFORM EEG DISCHARGES ON COGNITIVE FUNCTION

Patients with an established diagnosis of epilepsy were included in th ree groups on the basis of the absence (Group 2) or presence (Group 3) of epileptiform EEG discharges or subtle seizures (Group 4) during th e cognitive assessment procedure. A separate age-matched non-epileptic control group (Group 1) was formed. Twenty-five patients were include d in each of the four groups. Thus, a total of 100 patients were inves tigated. The patients were assessed with continuous 21-channel EEG and video-monitoring, combined with cognitive testing. The results show c onsistently lower performance on cognitive tests for Group 4, the grou p with subtle seizures. The difference with the control group was sign ificant for the intelligence subtests and for the complex information processing test (p<0.05). No transient cognitive impairment was found. The results are discussed in the Light of possible factors that may b e responsible for the lower test-scores in the patients of Group 4: bo th the ictal effects of the seizures themselves, postictal effects and the effects of the epileptiform EEG discharges may have had an impact on cognitive performance. Finally the absence of evidence for transie nt cognitive impairment in a group with frequent epileptiform EEG disc harges is discussed in detail.