Cognitive Disorders in Adults Treated for Epilepsy at University Teaching Hospitals in Ouagadougou, Burkina Faso

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Résumé

Objective: To study cognitive impairments in adult patients with epilepsy followed at university teaching hospitals in Ouagadougou.

Methodology: This was a descriptive and analytical cross-sectional study with prospective data collection, conducted from January 31 to August 30, 2024, in the neurology departments of Ouagadougou’s university hospitals. Data were collected using Kobo Collect software version 2022.3.6 and analyzed with Epi Info version 7.2.2.16. Quantitative variables were expressed as mean ± standard deviation, while qualitative variables were reported as counts and percentages. The Chi-square test was used to compare qualitative variables when sample sizes were ≥ 5; Fisher’s exact test was used for smaller samples (< 5). Student’s t-test was employed to compare quantitative variables. To identify factors associated with cognitive impairment, multivariable linear regression was performed following bivariate analysis. Statistical significance was set at p < 0.05.

Results: A total of 106 adult patients with epilepsy were included in the study, with a male predominance (66.98%) and a mean age of 34.88 ± 14.22 years. Clinically, 71.70% of patients experienced generalized seizures, and the mean duration of epilepsy was 10.69 years. EEGs were performed in 80.19% of patients and revealed epileptic paroxysmal
abnormalities in 63.53% of cases. The most commonly identified etiologies were central nervous system infections (19.81%), sequelae of traumatic brain injury (17.92%), and post-stroke sequelae (16.04%). Most patients (87.70%) were on monotherapy, with carbamazepine being the most frequently prescribed antiepileptic drug. Cognitive impairment
was identified in 60.38% of patients, with moderate to severe impairment in 12.13% of cases. The most affected domains were attention and calculation (53.77%), followed by memory (27.36%). Factors significantly associated with cognitive impairment included age ≥ 45 years (OR = 4.5; p = 0.0008), unpredictable seizure occurrence (nocturnal or diurnal) (OR = 5.7; p = 0.0000), and post-stroke epilepsy etiology (OR = 2.2; p = 0.007).

Conclusion: Cognitive impairment appears to be a common complication of epilepsy, underscoring the need for comprehensive screening and management—not only of epilepsy itself but also of cognitive deficits, which may further compromise patients’ quality of life and independence.

Mots-clés

Epilepsy; Adults; MMSE; Cognitive impairment; Age ≥ 45 years; Post-stroke sequelae