Cognitive dysfunction after generalized tonic‐clonic status epilepticus in adults

Cognitive dysfunction after generalized tonic‐clonic status epilepticus in adults INTRODUCTIONGeneralized tonic‐clonic status epilepticus (GTC‐SE) is considered to have a high risk of causing poor functional outcome in survivors, including cognitive impairment. Previous studies indicate that memory is the cognitive function most prone to decay in patients with epilepsy. The association is strongest for generalized tonic‐clonic seizures and correlates with seizure load. Experimental studies have demonstrated that the neocortex, thalamus, cerebellum and hippocampus are vulnerable to damage from GTC‐SE. The hippocampus, essential for memory formation and retrieval, seems particularly sensitive to prolonged seizures. MRI studies in humans have shown hippocampal oedema, sometimes followed by sclerosis. Neuropathology studies in patients dying after SE have found distinct hippocampal neuronal damage.It has been argued that intellectual prognosis in otherwise normal children with focal epilepsies is little influenced by an unprovoked GTC‐SE. However, 1 year after febrile SE, children had significantly smaller hippocampi than controls with simple febrile seizures. They also tended to have delayed motor and language development. Impaired cognitive function after GTC‐SE has been detected in children without previous developmental delay.Impaired cognitive function after GTC‐SE has been reported in adults. Dysfunctions may partially subside during weeks or months following GTC‐SE, which also has been suggested after focal SE. There are few systematic http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Acta Neurologica Scandinavica Wiley

Cognitive dysfunction after generalized tonic‐clonic status epilepticus in adults

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
Copyright © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
ISSN
0001-6314
eISSN
1600-0404
D.O.I.
10.1111/ane.12898
Publisher site
See Article on Publisher Site

Abstract

INTRODUCTIONGeneralized tonic‐clonic status epilepticus (GTC‐SE) is considered to have a high risk of causing poor functional outcome in survivors, including cognitive impairment. Previous studies indicate that memory is the cognitive function most prone to decay in patients with epilepsy. The association is strongest for generalized tonic‐clonic seizures and correlates with seizure load. Experimental studies have demonstrated that the neocortex, thalamus, cerebellum and hippocampus are vulnerable to damage from GTC‐SE. The hippocampus, essential for memory formation and retrieval, seems particularly sensitive to prolonged seizures. MRI studies in humans have shown hippocampal oedema, sometimes followed by sclerosis. Neuropathology studies in patients dying after SE have found distinct hippocampal neuronal damage.It has been argued that intellectual prognosis in otherwise normal children with focal epilepsies is little influenced by an unprovoked GTC‐SE. However, 1 year after febrile SE, children had significantly smaller hippocampi than controls with simple febrile seizures. They also tended to have delayed motor and language development. Impaired cognitive function after GTC‐SE has been detected in children without previous developmental delay.Impaired cognitive function after GTC‐SE has been reported in adults. Dysfunctions may partially subside during weeks or months following GTC‐SE, which also has been suggested after focal SE. There are few systematic

Journal

Acta Neurologica ScandinavicaWiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

References

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