Evaluate the efficacy of memantine on improving the cognitive impairment in patient with epilepsy

Epilepsy is a complex disorder, which involves much more than seizures, encompassing a range of associated comorbid health conditions that can have significant health and quality-of-life implications. Of these comorbidities, cognitive impairment is one of the most common and distressing aspects of epilepsy.

Excito-toxicity, mediated by glutamate acting on N-methyl-D-aspartate (NMDA) receptors in the hippocampus, can cause memory dysfunction in epilepsy .

Memantine is a low-affinity voltage-dependent uncompetitive antagonist of the NMDA-type glutamate receptor . It also has antioxidant property and increases production of brain derived neurotropic factor (BDNF)

Inclusion Criteria:

• Patients with idiopathic epilepsy.
• Normal brain imaging (CT brain).
• Patients on anti epileptic drugs more than 6 months.
• No more than two fits per month.
• Score of Mini mental state examination (10-24), mild and moderate cognitive impairment.
• No other medical disorders.

Exclusion Criteria:

• Progressive neurological diseases.
• Abnormal brain imaging (CT brain).
• More than two fits per month.
• Patients with severe cognitive impairment, score of MMSE less than10.
• Patients with severe medical disorders