�la� Tedavisine �yi Yan�t Veren Mezial Temporal Lob Epilepsili Hastalarda Tedavinin Bellek ve Y�r�t�c� ��levler �zerine Etkisi

ISSN 1300-7157

Anasayfa | �leti�im

Cilt : 27 Say� : 1 Y�l: 2021

�la� Tedavisine �yi Yan�t Veren Mezial Temporal Lob Epilepsili Hastalarda Tedavinin Bellek ve Y�r�t�c� ��levler �zerine Etkisi [Epilepsi]

Epilepsi. 2019; 25(2): 88-93 | DOI: 10.14744/epilepsi.2018.81488

�la� Tedavisine �yi Yan�t Veren Mezial Temporal Lob Epilepsili Hastalarda Tedavinin Bellek ve Y�r�t�c� ��levler �zerine Etkisi

Burcu Y�ksel¹, Sibel �eliker Uslu², Hande Sariahmetoglu³, Cahit Keskink�l��⁴, Dilek Atakl�³
¹Antalya E�itim ve Ara�t�rma Hastanesi, N�roloji Klini�i, Antalya
²Samsun E�itim ve Ara�t�rma Hastanesi, N�roloji Klini�i, Samsun
³Bak�rk�y Ruh ve Sinir Hastal�klar� E�itim ve Ara�t�rma Hastanesi, N�roloji Klini�i, �stanbul
⁴Bak�rk�y Ruh ve Sinir Hastal�klar� E�itim ve Ara�t�rma Hastanesi, N�ropsikoloji, �stanbul

G�R�� ve AMA�: �al��mam�zda ila� tedavisine iyi yan�t veren, tek tarafl� hipokampal sklerozu olan mezial temporal lob epilepsili (MTLE) hastalar�n, bellek ve frontal lob fonksiyonlar�n� inceleyerek antiepileptik ila�lar�n (AE�) kognisyon �zerine, s�k tekrarlayan n�betlerden ba��ms�z olarak etkisi olup olmad��n� ara�t�rmay� ama�lad�k.

Y�NTEM ve GERE�LER: Hastalar 2017 ILAE Revize N�bet S�n�flamas�na g�re s�n�fland�r�ld�. MTLE tan�s� alm�� olan, ilaca yan�tl� grup olarak en fazla iki AE� alan ve ayda ikiden az fokal fark�ndal��n bozuldu�u n�bet veya y�lda ikiden az fokalden iki tarafl� tonik kloni�e d�n��en n�bet ge�iren 34 hasta ve 30 benzer ya�, cinsiyet ve e�itim durumuna sahip sa�l�kl� kontrol �al��mam�za dahil edildi. �al��mam�zda monoterapi ve politerapi alan hastalar, bellek ve frontal lob fonksiyonlar� y�n�nden kar��la�t�r�ld�.

BULGULAR: Otuz d�rt hastan�n 19�u (%55.8) monoterapi, 15�i (%44.2) politerapi almaktayd�. Politerapi alan hastalar�n monoterapi alan hastalara g�re, s�zel belle�in �zellikle toplam ��renme parametresinin anlaml� d�zeyde d��k oldu�u, k�sa ve uzun s�reli g�rsel belle�in ve mant�ksal belle�in ileri d�zeyde etkilenmi� oldu�u g�r�ld� (p<0.05). Politerapi alan hastalar�n monoterapi alan hastalara g�re dikkat testinde ve verbal ak�c�l�k testinde ileri d�zeyde anlaml� bozulma saptand� (p<0.01).

TARTI�MA ve SONU�: Sonu� olarak kullan�lan AE� say�s� artt�k�a de�erlendirdi�imiz �o�u kognitif fonksiyonun performanslar�nda anlaml� d�zeyde etkilenme g�r�lm��t�r. Bu bulgular, AEݒlerin kognisyon �zerine olan olumsuz etkisini desteklemektedir.

Anahtar Kelimeler: Antiepileptik ila�lar, epilepsi, ilaca yan�t; mezial temporal lob epilepsisi.

The Effect of Antiepileptic Drug Therapy on Cognition in Drug-Responsive Mesial Temporal Lobe Epilepsy

Burcu Y�ksel¹, Sibel �eliker Uslu², Hande Sariahmetoglu³, Cahit Keskink�l��⁴, Dilek Atakl�³
¹Antalya Training and Research Hospital, Department of Neurology, Antalya, Turkey
²Samsun Training and Research Hospital, Department of Neurology, Samsun, Turkey
³Clinic of Neurology, Bak�rk�y Mental and Neurological Diseases Training and Research Hospital, Istanbul, Turkey
⁴Bak�rk�y Mental and Neurological Diseases Training and Research Hospital, Neuropsychology, �stanbul

INTRODUCTION: The aim of this study was to examine the effect of antiepileptic drugs on memory and executive functions in drug-responsive mesial temporal lobe epilepsy with unilateral hippocampal sclerosis (MTLE-HS).

METHODS: The patients were classified according to the 2017 International League Against Epilepsy classification of seizures. Thirty-four patients with the diagnosis of MTLE-HS and 30 matched controls were enrolled. Patients treated with a maximum 2 anti-epileptic drugs and experiencing no more than 2 instances of focal impaired awareness per month or 2 focal to bilateral tonic-clonic seizures in a year were accepted as drug-responsive. Patients receiving monotherapy (PRM) and polytherapy (PRP) were compared in terms of memory and executive functions.

RESULTS: 19 (55.8%) monotherapy patients in the group and 15 (44.2%) polytherapy patients. The maximum number of learned words recorded in a verbal memory test, the immediate and delayed recall score, and the logical memory score were all statistically significantly lower in the PRP group compared with the PRM group (p<0.05). The results of the verbal attention test and verbal fluency test were also significantly lower in the PRP group (p<0.01).

DISCUSSION AND CONCLUSION: Significantly greater impairment was observed in several aspects of cognitive function in the PRP group. These results indicate that antiepileptic drugs may have a negative impact on cognition.

Keywords: Antiepileptic drugs, epilepsy, drug responsiveness; mesial temporal lobe epilepsy.

Burcu Y�ksel, Sibel �eliker Uslu, Hande Sariahmetoglu, Cahit Keskink�l��, Dilek Atakl�. The Effect of Antiepileptic Drug Therapy on Cognition in Drug-Responsive Mesial Temporal Lobe Epilepsy. Epilepsi. 2019; 25(2): 88-93

Sorumlu Yazar: Burcu Y�ksel, T�rkiye

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