6th Edition of Neurology World Conference 2026

Abstract

Executive dysfunction is increasingly being noted in idiopathic epilepsy (IGE), even without structural brain abnormalities. We aimed to assess the frequency and pattern of frontal executive impairment in adults with IGE and to examine its clinical and socioeconomic correlates. In our study, 50 IGE patients with normal neuroimaging were assessed using the Frontal Assessment Battery (FAB) and Executive Interview (EXIT). We also documented demographic variables, seizure characteristics, antiepileptic drug (AED) therapy, and interictal EEG findings. Correlations between FAB scores and clinical variables were evaluated using Chi-square tests, t-tests, and correlation measures. 54% (27/50) of patients showed impaired FAB performance. Lexical fluency was the most affected in FAB (94%), followed by conceptualization (70%). Socioeconomic status correlated with executive impairment (72.7% abnormal FAB in low SES vs. 39.3% in middle SES; p = 0.024). Patients lacking a family history of seizures also had lower FAB scores (14.28 ± 2.68 vs. 16.43 ± 0.79; p = 0.039). No significant correlations were seen among FAB scores and age, gender, age at onset of seizures, seizure frequency, control, type or EEG abnormalities, duration of epilepsy, and AED regimen. Over half of adults with IGE had measurable executive dysfunction despite normal neuroimaging. Lexical fluency impairment was strikingly common. Socioeconomic disadvantage and negative family history act as significant predictors, implying roles for environmental and potentially occult neurobiological factors. Early cognitive screening may help in suggesting more individualised management strategies.