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April2012 Vol.49 Issue:        2        Table of Contents
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Cognitive Decline in Patients with Refractory Complex Partial Seizures

Mohamed Youssry A. El-Senousey1, Ashraf A. Aboelsafa1, Tarek M. El-Gammal1,Azza A. Ghali1, Yasser A. El-Heneedy1, Rania E. Mohamed2

Departments of Neuropsychiatry1, Radiology2, Tanta University; Egypt



Background: Patients with refractory complex partial seizures (CPS) are at a higher risk for mental and cognitive impairments. Objective: To evaluate the cognitive decline in patients with refractory CPS of temporal lobe origin. Methods: This study was carried out on 57 epileptic patients with temporal CPS. They were grouped into the refractory group (32 patients), subdivided into right (17 patients) and left (15 patients) subgroups, and the control group (25 patients) with controlled CPS. All patients were subjected to history taking, clinical neurological examination, electroencephalography (EEG), magnetic resonance imaging (MRI) of the brain, and neuropsychological assessment using:  Wechsler adult intelligence scale-revised (WAIS-R), Trail making test for assessment of attention, Digit span subtest of WAIS for assessment of immediate retention, and Bender Gestalt test for assessment of visual memory. Results: The digit span, Bender Gestalt and WAIS-R tests showed significantly lowered scores in the refractory group when compared to the control group (p<0.05). The mean score of the Trail making test showed a significantly longer time among patients with refractory than that of the control group (p<0.05). The WAIS-R has an inverse correlation with each of the duration of illness and the frequency of seizures. Hippocampal sclerosis ranked the first MRI abnormality. The EEG was concordant to MRI findings in hippocampal sclerosis. Conclusion: Patients with refractory CPS of temporal lobe origin are at higher risk for mental and cognitive impairments. Negative MRI studies in refractory CPS are still a challenge. [Egypt J Neurol Psychiat Neurosurg.  2012; 49(2): 149-156]

Key words: complex partial seizures, cognitive impairment, refractory seizures.

Correspondence to Ashraf A. Aboelsafa, Department of Neurology, Tanta University; Egypt. Tel:+20106622792. E-mail:

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