A community-based case–control study of prevalence and pattern of cognitive impairments in patients with epilepsy residing in South-Eastern Nigeria

Abstract

Background:Epilepsy is the commonest neurological disorder encountered in Sub-Saharan Africa. The quality of life of patients with epilepsy (PWEs) is adversely affected by cognitive impairments.Aim:This study investigated the prevalence and pattern of cognitive impairments in PWE in Ukpo community located in a South-Eastern state in Nigeria using Community Screening Interview for Dementia (CSID) and a computer-assisted cognitive test battery (FePsy).Methods and Patients:Fifty-one PWEs were studied and compared with 51 age-, sex-and level of education-matched healthy controls. Diagnosis of epilepsy was confirmed clinically with eye-witness corroboration. Sociodemographic data and information on epilepsy variables were obtained with the aid of a questionnaire. Cognitive domains assessed include language, memory, orientation, attention, psychomotor speed and constructional praxis.Results:The prevalence rate of cognitive impairment using total CSID score was 19.6%. Analysis of CSID scores revealed significant impairment in language (17.6%), memory (29.4%), orientation (15.7%), attention (7.8%) and constructional praxis (15.7%) compared to healthy controls. A similar pattern was observed with FePsy but with better sensitivity indices for detecting cognitive impairment.Conclusion:This study indicated significant prevalence rate of cognitive impairment among treatment-naïve PWE with profound affectation of memory, mental speed and language. In addition, the FePsy was found to be more sensitive and specific in assessment of cognitive function in PWE.

Epilepsy-associated neurocognitive disorders (EAND) in an onchocerciasis-endemic rural community in Cameroon: A population-based case–control study

“…Cognitive impairment is a frequently encountered but neglected problem in epilepsy [2,3,10,13]. To the best of our knowledge, this is the first study to systematically assess cognitive function of PWE in an onchocerciasis-endemic area in sub-Saharan Africa.…”

“…The prevalence of cognitive impairment in the adult population in sSA is estimated at 6.3% [47]. Studies in South Eastern Nigeria in 2016 [3] and in Taiwan in 2005 [48] reported prevalence values of 19.6% and 36% respectively of cognitive impairment in PWE. Another study of cognitive impairment in sub group of epilepsy patients living in an onchocerciasis endemic region in Democratic republic of Congo and specifically presenting nodding seizures revealed a prevalence of 71.9% [49].…”

“…Epilepsy is one of the most common neurological diseases, affecting more than 50 million individuals worldwide [1,2]. The burden of epilepsy is particularly important in sub-Saharan Africa (sSA) where the prevalence is between 2.2 and 58 per 1000 [3]. The values of prevalence of epilepsy in some parts of Cameroon are among the highest in the world, ranging from 11.6 to 134 per 1000 [4].…”

“…Neurocognitive disorders are increasingly being recognized as frequent and disabling complications of epilepsy. The frequency of cognitive impairment in epilepsy ranges between 20 and 72% [2,3,13]. Various cognitive domains can be affected including: verbal and visual memory, orientation, constructional praxis, language, executive functions, attention and psychomotor speed [3,14].…”

“…The frequency of cognitive impairment in epilepsy ranges between 20 and 72% [2,3,13]. Various cognitive domains can be affected including: verbal and visual memory, orientation, constructional praxis, language, executive functions, attention and psychomotor speed [3,14]. These defects have multiple causes, such as structural brain lesions, the seizures (and the secondary lesions they induce), and antiepileptic drugs [15].…”