Neurology
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Review Comparative Study
Cognitive outcomes and predictive factors in epilepsy.
Although most patients with epilepsy have normal cognitive abilities, they are at increased risk for cognitive deficits. Multiple factors contribute to this risk including antiepileptic drugs (AEDs), which not only reduce neuronal irritability but may also impair neuronal excitability. The major cognitive effects of AEDs are impaired attention, vigilance, and psychomotor speed, but secondary effects on other cognitive functions can be seen. ⋯ The cognitive profile of an AED is but one factor in the selection of therapeutic options. Ongoing seizures can be detrimental to both cognition and quality of life. Patients who are refractory or intolerant to AED therapy should be referred for video EEG monitoring to confirm the seizure diagnosis and determine if the patient is a candidate for epilepsy surgery.