Impairment of Social Cognition among Patients with Epilepsy: A CrossSectional Analytical Study in a Tertiary Care Center

Introduction: Social cognition is defined as one’s ability to perceive and understand other people’s thoughts, feelings, and behaviour and to respond appropriately. Many neurological disorders affecting the brain leads to disruption in social cognitive function. Many studies which were done among people with epilepsy showed impairment in social cognition, which in turn resulted in impaired quality of life, employability, and other cognitive functions especially in PWE with temporal lobe (TLE) and extratemporal (ETE) epilepsies. Identifying the nature and magnitude of social cognitive impairment in people with epilepsy has both theoretical and clinical implications, including the potential to form guidelines for clinical assessment and psychosocial intervention. Methodology: Patient more than 18-year-old with epilepsy and who are stable on antiseizure medication (ASM) were included in the study after taking consent. The quality of life of PWE was assessed using the 31-item Quality of Life in Epilepsy inventory (QOLIE-31 translated to local language) QOLIE31. Measures of social cognition include tests of emotion recognition (ER) and the assessment of theory of mind (ToM). Three cognitive tests were used to measure the patients’ ability to understand human emotion and behavior. Results: It was observed that those persons with epilepsy performed worse on ToM task compared to healthy controls. The performance of ToM task among different types of epilepsy was similar. There was significant negative association between ToM tasks and duration of epilepsy and number of antiseizure medication used. The overall quality of life and social function was better in patients who scored more in RMET (Reading of the Mind in the Eyes test) and FPRT (Faux Pas Recognition Test) tasks. Conclusion: Social cognition is significantly affected by seizure especially when the duration of seizure and number of ASM increases. Overall quality of life is also affected when there is impairment in social cognition. The study shows that a higher performance score in ToM tasks may not be essential to be in a good relationship.