Montreal Cognitive Assessment in cryptogenic epilepsy patients with normal Mini-Mental State Examination scores

This cross-sectional study examined the Montreal Cognitive Assessment (MoCA) performance in cryptogenic epileptic patients aged more than 15 years with normal global cognition according to the Mini-Mental State Examination (MMSE) score. We tested our hypothesis that the prevalence of mild cognitive impairment and associated patient correlation factors might be increased (score < 26) according to the MoCA, in spite of a normal MMSE score, and that cognitive impairment might occur in a range of domains of the MoCA. Eighty-five patients participated in this study. The mean MoCA score was 22.44 (+/- 4.32). In spite of a normal MMSE score, which was an inclusion criterion, cognitive impairment was detected in 60% patients based on the MoCA score. The variable that correlated with a higher risk of cognitive impairment was the number of antiepileptic drugs (polytherapy: OR 2.71; CI 1.03-7.15). The mean scores of visuospatial and executive function, naming ability, attention, language, abstraction, delayed recall and orientation among patients with mild cognitive impairment were significantly lower than those of patients with normal cognitive function. These findings suggest that mild cognitive impairment in cryptogenic epileptic patients is common. We suggest using MoCA as a screening test for patients with epilepsy.