Abstracts

Some reports point to the inverse correlation between depression and the presence of generalized seizures in focal symptomatic epilepsy. However, this issue is still controversial. In order to evaluate whether MTLE-HS patients with few tonic-clonic episodes have differences in the frequency of depressive or other psychiatric symptoms, we conducted the present study., In a retrospective case-control study we analyzed presurgical data of a group of 81 homogeneous MTLE-HS. Patients were divided in two sub-groups: a) group with rare generalizations ([italic]n[/italic]=40): no episodes to less than one episode of secondarily generalized tonic-clonic seizure per month; b) group with frequent generalization ([italic]n[/italic]=41): at least one or more generalized seizures per month. Patients were matched other varibles Psychiatric diagnosis was established by psychiatrists with experience in psychiatric disorders associated with epilepsy, and according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Patients were further classified for positive or negative psychiatric diagnosis and further sub-divided according to symptoms of depression or other psychiatric diagnostics. The magnitude of associations was measured by the O.R. (95% CI)., Psychiatric diagnosis was observed in 45 of the 81 patients (55%). In the group with rare generalization we observed 18 patients with psychiatric symptoms and 22 patients without psychiatric co-morbidities. In the group of frequent generalizations we observed 18 patients with psychiatric symptoms and 23 patients without psychiatric co-morbidities (O.R.=0.96; 95% C.I = 0.40 2.30; [italic]p[/italic]=1.00) . Regarding only depressive symptoms, in the group with rare generalizations, we observed 9 patients with depressive co-morbidities, and 31 patients without any history of depressive co-morbidities. In the group of frequent generalizations we observed 8 patients with depressive co-morbidities and 33 patients without any psychiatric depressive co-morbidities (O.R. = 0.83; C.I=0.29-2.44; [italic]p[/italic]=0.79)., Our results do not support the hypothesis that secondary generalized tonic-clonic seizures affect the frequency of depressive symptoms, depression, or other psychiatric co-morbidities in MTLE-HS patients. However, further studies with larger samples are necessary to confirm our results and to assess the impact of surgery in seizure control and its influences in psychiatric co-morbidities., (Supported by FAPESP)