Abstracts

There are evidences that psychiatric disorders (PD) in people with epilepsy may be determined by the occurrence of CNS structural and/ or functional changes. Recent advances in neuroimaging techniques have demonstrated the presence of frontal lobe abnormalities, especially in the prefrontal cortex, in subjects with PD. The purpose of this investigation is to analyze the presence of frontal lobe dysfunction (FLD) in children and adolescents with epilepsy and determine its correlation with the occurrence of PD, especially mood disorders., The authors evaluated 13 temporal lobe epilepsy (TLE) subjects (mean age 12.5 yrs); 7 (53.85%) children with mesial TLE, 6 (46.15%) with lateral TLE and 21 healthy control. Patients were submitted to a comprehensive neuropsychological testing in order to evaluate the attentional and executive functions composed by the Wisconsin Card Sorting Test (WCST), the Matching Familiar Figures Test (MFFT), Verbal fluency for animals and food and the subtests Digits (WISC-III) and Finger Windows (WRAML). Patients were interviewed by a child psychiatrist using KIDDIE-SADS and were classified according to DSM IV and CID 10., 76.9% (10/13) patients had FLD and 69.2% (9/13) had a PD. Out of ten patients with FLD, 80% (8/10) had a PD, being 60% (6/10) of those diagnosed with a mood disorder.
Six (75%) out of 8 patients with PD and FLD had a severe executive dysfunction characterized by failure in at least five subtests compared to the normal controls.
In the group of 8 patients with FLD and PD, six had mesial TLE. In this group with mesial TLE, 83.3% (5/6) patients had mood disorders and 83.3% (5/6) had a severe executive function impairment., These preliminary data suggest the existence of an association between FLD and PD in children and adolescents with TLE. That association seems to be more robust especially in those subjects with damage to the mesial temporal lobe structures. This corroborates previous neuroimaging findings showing widespread changes not restricted to the temporal lobes in patients with TLE and depression. This investigation highlights the belief that PD and epilepsy may represent epiphenomenon as opposed to a cause-consequence relationship., (Supported by FAPESP no..)