Background: Cognitive impairments are common in children with epilepsy not only in children with refractory epilepsy or with remote symptomatic causes but idiopathic and benign epilepsies may also lead to impairments in several domains of cognitive functions. Psychometric tests as Stanford-Binet test and Wechsler Intelligence Scale for Children (WISC) take a long time to administer, are expensive and need a well-trained psychologist, so a simpler screening test is needed in children with epilepsy.
Objective: Assessment of modified mini mental state examination (modified MMSE) as rapid diagnostic tool for detection of cognitive impairment in children with epilepsy aged from 6 to 12 years.
Methods: This cross-sectional comparative study was conducted in pediatric neurology outpatient clinic of El-Hussein University Hospital, Cairo, Egypt during the period from May 2019 to April 2020 and included 56 children aged 6 to 12 years with epilepsy. They were selected by simple random method. All subjects were evaluated for cognitive impairment using the Modified MMSE and then re-evaluated by a gold-standard cognitive evaluation test using the Stanford-Binet Intelligence Scales, Fifth Edition administered by a psychologist.
Results: In our study, the prevalence of cognitive impairment in children with epilepsy aged from 6 to 12 years was 57.14% (32 out of 56 patients) identified by Modified MMSE and it was 58.92% identified by Stanford Benet test (33 out of 56 patients) with no statistically significant difference. The highest mean of MMSE cognitive domains was for languages (9.0 ± 1.66) then orientation (5.83 ± 2.98) while the lowest domain was for recall (2.33 ± 0.84). Modified MMSE had a sensitivity of 93.93%, specificity of 95.65%, an accuracy of 94.94%, positive predictive value of 96.87%, and negative predictive value of 91.66%.
Conclusions: Cognitive impairment is common in children with epilepsy. Modified MMSE is a rapid and valid diagnostic test, so it may be useful for detection of cognitive impairment in children with epilepsy.