The concordance between electro-clinical finding, brain imaging and neuropsychological assessment in patients with focal drug resistant epilepsy / Mona Kamel Abdelfattah Kamel Moawad ; Supervised Nirmeen Adel Kishk , Marwa Farghaly Ahmed , Reham Mohamed Shamloul

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Neurosurgery

Background: Drug resistant epilepsy (DRE) account for nearly 30% of people with epilepsy (PWE), which is associated with increasing risk of morbidity and mortality. Aim of work:study the utility of the available non-invasive assessment (electro-clinical, radiological, and neuropsychological assessment) to achieve concordance. Patients and Methods: 118 PWE were recruited from Kasr Alainy hospital, epilepsy outpatient clinic with focal DRE.These patients clinical history data was collected, Electroencephalograph (EEG) interictal/ictal (when available), and brain imaging (MRI epilepsy protocol).Neuropsychological assessment by Wechsler Adult Intelligence Scale (WAIS-IV),proposed Neuropsychological assessment battery, assessment of hemispheric dominance(by digit dichotic listening),and mood assessment was done. Collected data were analyzed and concordance between assessment modalities were done. Results: among recruited patients, 37.3% of patients had ictal EEG recorded; lesional brain imaging was detected in 80.5% of patients. Concordance of seizure semiology, EEG, and brain imaging, regarding lateralizing and localizing value,showed that 24.6% of patients achieved complete concordance, 38.1% of patients had partial concordance, and 37.3% of patients needed further investigation.Impairment of intellectual abilities among patients, where 67.3% of patients showed FSIQ was less than average. Neuropsychological assessment battery could achieve cognitive profile of the patients with poor lateralizing value.Digit dichotic listening was conclusive in assessment of hemispheric dominance in 70.5% of assessed patients

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