Evaluation of Cognitive Functions of Patients with Epileptic Seizures Originating From the Posterior Cortex

Abstract

Objectives:Posterior cortex epilepsies (PCE) are characterized by seizures originating from the occipital, parietal, or occipital border of the temporal lobe. It is very important to analyze the patient series and bring them to the literature in the evaluation of the clinical features of this rare seizure type. In our study, the patients with PCE were retrospectively examined and the cognitive functions of the patients were evaluated and the results were compared with those of temporal lobe epilepsy (TLE).Methods:Patients who fulfilled the inclusion criteria among epilepsy patients treated in Cerrahpaşa Faculty of Medicine, Department of Neurology were retrospectively screened and included in this study. As a result of the described findings, cases where localization could be made to the posterior or temporal lobe were included in the study and two separate study groups were formed: Group-1; Posterior cortex patients, Group-2; Temporal cortex patients. A control group without any neurological or psychiatric disease was also formed. Detailed neurocognitive tests were applied to all 3 patient groups.Results:There was no significant difference between the demographic data of the control and patient groups. In all the parameters studied, the test results of Group-1 were found to be lower than the control group. The variables that best differentiated the control group from Group-1 and 2 were determined as ‘Rey–Osterrieth complex figure test (ROCF)’, ‘Trail Making Test (TMT) Form A’, ‘The Judgment of Line Orientation (JLO) test and California Verbal Learning Test (CVLT) delayed recall’ scores.Conclusion:Our findings suggest that both posterior epilepsies and TLE are associated with impairments in visual configuration, verbal skills, and executive functions. From these results, deterioration in visual configuration is an expected result in PCE, whereas deterioration in verbal skills and executive functions is considered an unexpected result in PCE cases since it is typically controlled by the fronto-temporal regions. It was suggested that it would be useful to follow up the patients with a comprehensive cognitive assessment.

Keywords

• cognitive functions
• occipital epilepsy
• posterior cortex epilepsy