Background and Aim: Epilepsy often leads to cognitive impairment. Idiopathic generalized epilepsy as a group is considered to be benign in terms of its effects on cognition. Though, neuropsychological testing reveals subtle frontal impairment in patients with juvenile myoclonic epilepsy (JME). The aim of this study is to evaluate cognitive dysfunction in patients with JME. Method: We compared 50 JME patients and 50 age and sex matched healthy controls above 12 years of age on various cognitive tests which included Mini Mental State Examination (MMSE), Frontal Assessment Battery (FAB), Executive Interview (EXIT), PGI Memory Scale (PGIMS), Clock Drawing Test (CDT), Cube copying test (CCT), and Nahor Benson Test (NBT). We correlated the cognitive dysfunction with education level, age of onset, duration of epilepsy, electroencephalogram (EEG) abnormalities, treatment, and seizure control status. Results: JME patients performed significantly worse on MMSE (P = 0.001), PGI MS (P value = 0.001), FAB (P =.001), EXIT (P =.001), CDT (P =.02), and CCT (P =.001) when compared to the controls. JME patients had impaired attention, verbal fluency, design fluency, verbal memory, visual memory, conceptualization, set shifting, mental flexibility, response inhibition, and visuospatial functions. Cognitive dysfunction correlated with education level, duration of epilepsy and EEG abnormality. No correlation was seen with seizure frequency or type of antiepileptic therapy. Conclusions: JME patients demonstrate both frontal and parietooccipital lobe dysfunction. Hence detailed higher mental function tests supplemented by functional neuroimaging studies should be done in JME patients for their comprehensive management. This would also enhance our knowledge about the pathogenesis of JME.


中文翻译：

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青少年肌阵挛性癫痫 (JME) 的认知功能障碍——一项三级护理中心研究



背景和目的：癫痫常常导致认知障碍。就其对认知的影响而言，特发性全身性癫痫被认为是良性的。然而，神经心理学测试显示青少年肌阵挛性癫痫（JME）患者的额叶有轻微的损伤。本研究的目的是评估 JME 患者的认知功能障碍。方法：我们对 50 名 JME 患者和 50 名年龄和性别匹配的 12 岁以上健康对照者进行了各种认知测试的比较，其中包括简易精神状态检查 (MMSE)、额叶评估电池 (FAB)、高管访谈 (EXIT)、PGI 记忆量表(PGIMS)、时钟绘图测试 (CDT)、立方体复制测试 (CCT) 和 Nahor Benson 测试 (NBT)。我们将认知功能障碍与教育水平、发病年龄、癫痫持续时间、脑电图（EEG）异常、治疗和癫痫控制状态相关联。结果： JME 患者在 MMSE ( P = 0.001)、PGI MS ( P值 = 0.001)、FAB ( P = .001)、EXIT ( P = .001)、CDT ( P = .02) 和 CCT 方面表现明显较差( P =.001) 与对照组相比。 JME 患者的注意力、言语流畅性、设计流畅性、言语记忆、视觉记忆、概念化、设定转换、心理灵活性、反应抑制和视觉空间功能受损。认知功能障碍与受教育程度、癫痫持续时间和脑电图异常相关。未发现癫痫发作频率或抗癫痫治疗类型存在相关性。结论： JME 患者表现出额叶和顶枕叶功能障碍。 因此，应对 JME 患者进行详细的高级心理功能测试，并辅以功能性神经影像学研究，以进行综合管理。这也将增强我们对 JME 发病机制的了解。