Authors :
Presenting Author: Lama Rayyis, MBBS – King Faisal Specialist Hospital and Research Centre, Jeddah
Fawzi Babtain, MBBS,MHSc, FRCPC, CSCN (EEG, EMG) – Neurology, Epilepsy, Neurosciences, King Faisal Specialist Hospital aand Research Center; Sarah Alshehri, MBBS – Epilepsy Fellow, Neurosciences, King Faisal Specialist Hospital aand Research Center; Mohammed Al Mansour, MBBS – Epilepsy Fellow, Neurosciences, King Faisal Specialist Hospital and Research Centre; Youssef Al said, MBBS, FRCPC – Epileptologist, Neurosciences, King Faisal Specialist Hospital aand Research Center
Rationale: In this study, we aim to assess the ability of the Montreal Cognitive Assessment (MoCA) test to discriminate the cognitive profile between temporal lobe epilepsy (TLE) and frontal lobe epilepsy (FLE) as a bedside concise tool.
Methods: In this cross-sectional study, we recruited patients who had TLE and FLE, based on a comprehensive pre-surgical epilepsy evaluation. We relatively matched both groups for age, sex and education level. We obtained MoCA test in each patient and compared the results between TLE and FLE, taking into consideration the score of each cognitive domain separately, demographics, risk factors, etiology, and disease duration.
Results: We studied 40 patients who were predominantly male (65%), the mean age was 33 years, and the mean age at diagnosis was 17 years, and were on two to three antiepileptic drugs. The median MoCA score was 24 (IQR; 21, 26) (Table 1). There were 22 patients with TLE and 18 with FLE. A Wilcoxon rank sum test showed significantly higher attention in TLE than FLE cases (six versus 4, W=127, p-value=0.04). This difference was prominent in TLE 33 years and younger (5.1, 4, W = 21, p-value = 0.04) (Figure 1). Also, attention scores correlated significantly with age in TLE cases (p-value = 0.05) (Figure 2). Finally, higher attention scores in patients 33 years and younger were about four times more likely to be seen in patients with TLE, but this association was not observed in older patients or the whole group (OR=3.56, p-value=0.04) (Table 2).
Conclusions: The attention domain of the MoCA test demonstrated promise in distinguishing between TLE and FLE, albeit with limitations due to the sample size. Further research is warranted to validate these findings and establish their clinical significance.
Funding: No funding was received for this work