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Neuropsychology of late-onset epilepsies.
Helmstaedter, C; Tailby, C; Witt, J-A.
Affiliation
  • Helmstaedter C; Department of Epileptology, University Hospital Bonn (UKB), 53127 Bonn, Germany. Electronic address: C.Helmstaedter@uni-bonn.de.
  • Tailby C; Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, 3084, Australia; Florey Department of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria 3010, Australia; Department of Clinical Neuropsychology, Austin Hospital, Heidelberg, Victoria, 3084, Australia.
  • Witt JA; Department of Epileptology, University Hospital Bonn (UKB), 53127 Bonn, Germany.
Seizure ; 2024 Mar 26.
Article in En | MEDLINE | ID: mdl-38555201
ABSTRACT
In an increasingly ageing society, patients ageing with epilepsy and those with late-onset epilepsies (LOE) represent a challenge for epilepsy care and treatment. Senescence itself bears risks of pathologies which in the form of acute focal damage (e.g. stroke) or slowly progressive degenerative damage can cause seizures and substantial cognitive impairment. There is converging evidence from studies in LOE that cognitive impairments are present from epilepsy onset before treatment is initiated and may even precede the emergence of seizures. This suggests that these impairments (like the seizures) are expressions of the underlying disease. Indeed, both seizures and cognitive impairments can be early indicators of disease conditions which lead to mental decline. Cognitive decline over time poses the challenge of disentangling the interrelation between seizures, treatment effects and underlying disease. This issue must be considered as some of the etiologies for causing neuropsychological decline can be addressed. Medication and active epilepsy can contribute to impairments and their impact may be reversible. Dementia is rare if seizures are what has brought the person to attention, and if this is not accompanied by other slowly developing features (such as cognitive of psychiatric changes). From a neuropsychological point of view choosing the right screening tools or assessments, obtaining the history and timeline of impairments in relation to epilepsy, and most importantly longitudinally following the patients regardless of whether epilepsy is ultimately controlled or not appear essential.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Seizure Journal subject: NEUROLOGIA Year: 2024 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Seizure Journal subject: NEUROLOGIA Year: 2024 Document type: Article
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