Sensitivity of Montreal Cognitive Assessment in Comparison with Mini Mental Status Examination in Testing Cognitive Status in Epilepsy Patients with Phenytoin Monotherapy

Background and objective: Most studies follow Mini Mental Status Examination (MMSE) to assess cognitive status in epilepsy population with phenytoin monotherapy, however its sensitivity on detecting cognition in this population remains debatable. Previous study observed Montreal Cognitive Assessment (MOCA) being more sensitive in testing cognitive status in patients with stroke, parkinsonism, cardiovascular events, epilepsy etc. Therefore, in the present study, we examined the sensitivity of MOCA compared with MMSE in testing the cognitive status in epilepsy population with phenytoin monotherapy. Method: This case-control study enrolled 63 newly diagnosed epilepsy patients (controls) and 60 epilepsy patients with phenytoin monotherapy up to one year. Both controls and cases were screened using MMSE and MOCA for cognitive function.
Results: MOCA showed cognitive impairment 70% in controls and 100% in cases as compared to 12% in controls and 94% in cases with MMSE. Our findings indicate that MOCA could detect cognitive impairment that failed with MMSE in both controls and cases, possibly the MOCA subscales contributed to contributed to higher sensitivity of MOCA as compared to MMSE.
Conclusion: MOCA was found to be more sensitive and reliable than MMSE in testing the cognitive status in epilepsy population with phenytoin monotherapy.

Author(s): Rajendran Natham, Palanisamy Amirthalingam, Narmadha Mukunthu and Ganesvaran Arunachalam

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