Current Literature in Clinical Science 117 DO SEIZURES HARM THE BRAIN? Cognitive Decline in Severe Intractable Epilepsy

PURPOSE: To explore the relation between seizure-related variables and cognitive change in patients with severe in-tractable epilepsy. METHODS: A retrospective analysis of data from 136 pa-tients who had undergone a cognitive assessment on two occasions at an interval of ≥10 years. Cognitive measures included tests of memory and executive skills in addition to intelligence quotients (IQ). Details were available regarding seizure type and frequency in the intertest interval. RESULTS: Cognitive decline was severe and occurred across a wide range of cognitive functions. The frequency of generalized tonic–clonic seizures was the strongest pre-dictor of decline. Complex partial seizure frequency was associated with a decline in memory and executive skills but not in IQ. Seizure-related head injuries and advancin