Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
J Clin Neurosci. 2020 Mar;73:31-36. doi: 10.1016/j.jocn.2020.02.003. Epub 2020 Feb 21.
The objective of this study is to determine prevalence and factors leading to verbal learning and memory dysfunction among patients with epilepsy. A total of 211 subjects were recruited. Their verbal memory was assessed by Rey's Auditory Verbal Learning Test (RAVLT). This test was further subdivided into four major spheres for analysis, namely the verbal learning, interference list, immediate memory and delayed memory. All data collected were analyzed using Statistical Package for Social Sciences. Among the 211 patients, 55% (n = 116) had focal seizures and the remaining 45% (n = 95) had generalized seizures. Prevalence of verbal learning and memory impairment was high at 39.97% overall, and found most commonly in patients with focal impaired awareness seizures. Verbal learning and immediate memory dysfunction were significantly lower in focal impaired awareness group compared to others. Age more than 50 years, exposure to three or more antiepileptic drugs and use of carbamazepine more than 1000 mg a day were the predictors in poor verbal memory outcome. No statistical difference was observed in the mean RAVLT scores among the gender and hand dominance groups. Between patients with and without electroencephalogram changes as well as brain magnetic resonance imaging changes, the mean RAVLT scores showed no statistically significant difference. Verbal learning and memory impairment is prevalent among the epilepsy patients. The consequences of the memory impairment can be as debilitating as the seizure control. RAVLT is a reliable and practical test in the clinical setting.
本研究旨在确定癫痫患者言语学习和记忆功能障碍的患病率及相关因素。共招募了 211 名受试者。他们的言语记忆通过 Rey 听觉言语学习测试（RAVLT）进行评估。该测试进一步分为四个主要领域进行分析，即言语学习、干扰列表、即时记忆和延迟记忆。收集到的所有数据均使用社会科学统计软件包进行分析。在 211 名患者中，55%（n=116）有局灶性发作，其余 45%（n=95）有全面性发作。言语学习和记忆障碍的总患病率为 39.97%，在局灶性意识障碍性发作患者中最为常见。与其他组相比，局灶性意识障碍组的言语学习和即时记忆功能障碍明显更低。年龄超过 50 岁、暴露于三种或三种以上抗癫痫药物和每天使用卡马西平超过 1000mg 是言语记忆不良结局的预测因素。在性别和惯用手优势组中，RAVLT 评分的平均值没有统计学差异。在有脑电图和脑磁共振成像改变的患者与无改变的患者之间，RAVLT 评分平均值没有统计学上的显著差异。言语学习和记忆障碍在癫痫患者中较为常见。记忆障碍的后果可能与癫痫发作控制一样严重。RAVLT 在临床环境中是一种可靠且实用的测试。
