Cognitive Testing during Partial Seizures

.Long-term monitoring (LTM) is an established diagnostic procedure essential for achieving an effective management of medically refractory epileptic seizures. While automation of LTM enables cost-effective documentation of randomly recurring electro-clinical seizures, the cognitive state of patients during a seizure, an important aspect for seizure classification, remains poorly studied.Our LTM experience showed discrepancies between some patients' personal accounts of their seizures and their actual video documented behavior. In response, the Cognitive Testing System (CTS) was introduced as an integral part of LTM to objectively evaluate a patient's cognitive state.Preliminary data based on forty patients with partial seizures studied by the CTS indicate that it extends LTM capability by probing the level of ictal and peri-ictal awareness of a patient in a consistent, objective, and definable manner. We believe that the consistent identification of initial cognitive disturbances by CTS application will assist in defining seizure loci and may provide insights into both epileptogenic mechanisms and normal cerebral functions.