Rationale:
Epilepsy is a neurological disorder with significant cognitive and psychosocial implications; affects memory, attention, executive functions, and language, leading to challenges in education, employment, and relationships. Additionally, the bidirectional link between epilepsy depression and anxiety further complicates patient outcomes. Understanding these factors in economically active young patients is vital for improving their management and quality of life.
Methods:
An observational, analytical, case-control study was conducted, approved by the Research Ethics Committee (Approval No. 17-24). The study included patients aged 15 to 50 years with well-documented epilepsy etiology, confirmed through EEG, MRI, and a comprehensive clinical history. The patient group was compared with controls who shared similar socio-cultural characteristics. Both groups were evaluated using validated screening tools for the Mexican population, including the Beck Anxiety Inventory, PHQ-9, the Montreal Cognitive Assessment (MoCA) Version 8.2, and the Addenbrooke’s Cognitive Examination (ACE-III).
Results:
A total of 25 patients (P) and 25 controls (C) were evaluated, with both groups matched appropriately for age (p=0.65), gender (p=0.765), and education level (p=0.846). Among the patients, 68% had focal epilepsy, 28% had generalized epilepsy, and 4% had an unknown onset. The most common diagnosis was Mesial Temporal Sclerosis (44%), followed by Juvenile Myoclonic Epilepsy (20%). Most patients (68%) were on monotherapy, with levetiracetam being the most commonly used drug (68%), followed by carbamazepine (24%) and valproate (20%). Seizure control was generally good, with 80% of patients experiencing fewer than 1 to 3 seizures in the last 3 months.
There was no significant difference in anxiety levels between the groups (P mean 22.24 vs. C 17.24, p=0.22) or in depression levels (p=0.800). However, a significant difference was observed in the MoCA scores (P 20.7 vs. C 24.28, p=0.044). The mean ACE-III score was lower in patients (P 69.09 vs. C 81.32, p=0.206), with 20% of patients scoring above 80 compared to 64% of controls (p=0.002). Controls outperformed patients in attention (p=0.041), memory (p=0.048), clock-drawing (p=0.004), and cube-copying (p< 0.001). Additionally, verbal fluency (≥11 words/min) was higher in controls (P 36% vs. C 72%, p=0.011), as was semantic fluency (≥17 words/min) (P 25% vs. C 56%, p=0.027).