Mental deterioration in epilepsy.

A variety of factors could potentially influence the occurrence of mental deterioration in epilepsy, including seizure type, age of seizure onset, seizure duration, and seizure severity. The available literature suggests that measures of severity are more predictive of progressive decreases in intellectual functioning. There is also evidence suggesting that seizure severity and cognitive deterioration might both be the result of underlying pathophysiologic abnormalities in some cases. In the majority of patients with epilepsy, however, with relatively less severe disease, there is little evidence for cognitive deterioration. Total seizure number also has an inverse correlation with level of psychosocial functioning in some studies, whereas others have found that patients with emotional difficulties have fewer seizures. In the case of emotional deterioration, the impact of interpersonal relationships and other environmental factors upon psychosocial outcome seems clear, and the evidence for specific pathophysiologic explanations for emotional deterioration, less convincing.