CORRELATION OF COGNITIVE FUNCTIONS AND LOCATION OF FOCAL EPILEPSY IN RSUP DR. MOHAMMAD HOESIN PALEMBANG

Abstract

ABSTRAK

Latar belakang: Gangguan kognitif merupakan salah satu konsekuensi epilepsi yang paling sering terjadi dan berdampak besar pada kehidupan pasien. Epilepsi lobus temporal adalah jenis epilepsi fokal yang paling umum ditemukan dan dilaporkan berhubungan erat dengan gangguan kognitif. Pasien sindrom epilepsi fokal lainnya seperti epilepsi lobus frontal, parietal, dan oksipital diketahui juga mengalami gangguan kognitif meskipun studinya belum sebanyak epilepsi lobus temporal.  Belum diketahui secara pasti kaitan antara fokus epileptik tertentu dengan komplikasi gangguan kognitif pada penderitanya.

Tujuan: Penelitian ini dilakukan untuk mengetahui hubungan fungsi kognitif dengan lokasi epilepsi fokal di poliklinik neurologi RSUP Dr. Mohammad Hoesin Palembang.  

Metode: Penelitian ini merupakan penelitian observasional analitik dengan pendekatan cross sectional. Penelitian ini dilakukan di Instalasi Rekam Medik RSUP Dr. Moh. Hoesin (RSMH) Palembang untuk mengambil data sampel yang berobat pada rentang waktu 1 Januari 2019-31 Desember 2019 dan di poliklinik Neurologi untuk mengambil data pasien yang berobat pada rentang waktu 1 Juli-31 Agustus 2020. Data lokasi epilepsi fokal berdasarkan sindrom klinis, usia onset epilepsi, jenis kelamin, pendidikan, frekuensi dan lama bangkitan, lama menderita epilepsi serta jenis obat antiepilepsi (OAE) didapat melalui data rekam medis dan fungsi kognitif diketahui melalui pemeriksaan Montreal Cognitive Assessment versi Indonesia yang telah divalidasi (MoCA-Ina). Analisis data dilakukan dengan menggunakan program SPSS 22 for windows.

Hasil: Dari 42 sampel penelitian, sebanyak 29 orang (69%) telah mengalami penurunan fungsi kognitif dan hanya 13 orang (31%) yang fungsi kognitifnya masih normal. Analisis korelasi antara fungsi kognitif dan lokasi epilepsi fokal menghasilkan koefisien korelasi 0,107 (korelasi lemah) dengan nilai p 0,365 (tidak bermakna). Faktor-faktor lainnya seperti usia onset, tingkat pendidikan, frekuensi bangkitan, lama bangkitan, jenis pengobatan, lama menderita epilepsi dan durasi makan OAE juga tidak berhubungan dengan fungsi kognitif pasien pada penelitian ini.

Kesimpulan: Secara statistik tidak ada hubungan langsung antara fungsi kognitif dan lokasi epilepsi fokal. Banyak faktor yang dilaporkan memengaruhi fungsi kognitif pasien epilepsi sehingga kecil kemungkinan satu faktor tunggal dapat memastikan terjadinya gangguan kognitif pada pasien epilepsi.

Kata kunci: lokasi epilepsi fokal, fungsi kognitif, MoCA-Ina

ABSTRACT

Background: Cognitive impairment is one of the most common consequences of epilepsy and has a major impact on the patient's life. Temporal lobe epilepsy is the most common type of focal epilepsy and is reported to be closely associated with cognitive impairment. Patients with other focal epilepsy syndromes such as frontal, parietal, and occipital lobe epilepsy are also known to experience cognitive impairment, although studies are not as numerous as temporal lobe epilepsy. The relationship between certain epileptic foci and complications of cognitive impairment in patients is not yet certain.

Purpose: This study was conducted to determine the correlation between cognitive function and the location of focal epilepsy in the neurology clinic of  RSUP Dr. Mohammad Hoesin (RSMH) Palembang.

Method: This research is an analytic observational study with a cross sectional approach. This research was conducted at the RSMH Palembang to collect secondary data from medical records of outpatients between 1 January 2019-31 December 2019 and at the Neurology Clinic to collect primary data on patients seeking treatment between 1 July-31 August 2020. Focal epilepsy location data based on clinical syndrome, age of epilepsy onset, gender, education, frequency and duration of seizures, duration of epilepsy, type of antiepileptic drugs (AED), and duration of consuming AED were obtained through medical record and cognitive function was examined using the validated Indonesian version of the Montreal Cognitive Assessment (MoCA-Ina). Data analysis was performed using the SPSS 22 for windows program.

Result: From 42 samples, 29 people (69%) had decreased cognitive function and only 13 people (31%) had normal cognitive function. The correlation analysis between cognitive function and focal epilepsy location resulted in correlation coefficient of 0.107 (weak correlation) with p value of 0.365 (not significant). Other factors such as age of onset, level of education, frequency of seizures, duration of seizures, type of treatment, duration of epilepsy and duration of taking AED were also not associated with cognitive function of patients in this study.

Conclusion: Statistically, there was no direct correlation between cognitive function and the location of focal epilepsy. Many factors have been reported to affect cognitive function in epileptic patients, so it is unlikely that one single factor can be sole factor causing cognitive impairment in epilepsy patients.

Keywords: focal epilepsy location, cognitive function, MoCA-Ina