Do recent seizures and recent changes in antiepileptic drugs impact performances on neuropsychological tests in subtle ways that might easily be missed?

Abstract:

PURPOSE:The possibility that a recent seizure or a recent change in antiepileptic medication might produce an occult change in neuropsychological performance is of interest, and especially so in the context of evaluation for epilepsy surgery. Such an evaluation is often done in a setting of video-EEG monitoring where a strong effort is made to produce seizures as quickly as possible with abrupt changes in medication, alterations in sleep, etc., which could impact the validity of neuropsychological findings. METHODS:A total of 126 adults were studied who had seizures of strictly temporal origin (47 right, 79 left) and whose recent medication history and seizure occurrence prior to testing was as clear as possible. All were tested with an extensive neuropsychological battery with great attention to giving tests only when the patients appeared clinically not to be suffering from recent seizures (seizures occurring on the day of testing or on the day prior to testing) or medication change effects. The cognitive correlates of side of seizures were also evaluated in order to provide a strength-of-effect comparison with recency of AED changes and seizures. RESULTS:Findings from three-way ANOVA showed a possible slight adverse effect of recent AED change, no effects of recent seizures, and a sizeable relationship with side of seizures. A simultaneous consideration of all three of these variables did not provide additional findings of interest. CONCLUSIONS:Although it is not possible to completely rule out some subtle cognitive effects of recent changes in medication or recent seizures, this investigation does not provide evidence for such effects when the neuropsychological evaluation is conducted carefully with no testing during any questionable or definite postictal periods.

journal_name

Epilepsia

journal_title

Epilepsia

authors

Dodrill CB,Ojemann GA

doi

10.1111/j.1528-1167.2007.01140.x

subject

Has Abstract

pub_date

2007-10-01 00:00:00

pages

1833-41

issue

10

eissn

0013-9580

issn

1528-1167

pii

EPI1140

journal_volume

48

pub_type

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