Exploring the use of neuropsychological testing for pre-surgical evaluations of patients with epilepsy in Mongolia using the Repeatable battery for the Assessment of neuropsychological Status (RBANS)

Objective: Neuropsychological testing is an essential component of the pre-surgical evaluation for patients with epilepsy. However, no known validated neuropsychological assessment exists for use in Mongolia. This exploratory study evaluates the use of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Update in Mongolian patients with epilepsy. Methods: Fifty-nine patients with localized drug-resistant epilepsy in Mongolia completed a nonvalidated translated version of the RBANS as part of their pre-surgical workup. Multivariate analyses of variance were conducted to compare cognitive performance across clinical groups defined by seizure lateralization and localization. Results: Twenty-five patients had dominant hemisphere epilepsy (DHE), 29 had non-dominant hemisphere epilepsy (NDHE), and 5 had bilateral onsets. Thirty-eight patients had temporal lobe epilepsy (TLE), 13 had frontal lobe epilepsy (FLE), and 8 had multi-focal epilepsy. Patients with DHE performed significantly worse across verbal memory tasks (ps < .05) than those with NDHE. Furthermore, patients with TLE scored significantly lower on several learning and memory tasks than those with FLE (ps <.05). Additionally, measures of intra-individual variability provided further clinical information regarding localization and lateralization. Significance: RBANS performance patterns in this Mongolian cohort align with established neuropsychological findings in epilepsy. This exploratory study lays the groundwork for the use of neuropsychological testing as part of the pre-surgical workup in Mongolia, as well as in other areas with limited medical resources that do not yet have validated neuropsychological measures.