Abstracts

We performed a retrospective review of 83 patients referred from the Community Mental Health Center for Forsyth County, North Carolina to Epilepsy Institute of North Carolina-Department of Neuropsychology -Social Work for the years 2003 and 2004. These patients were referred for neuropsychological testing due to behavioral reasons: suspected conduct disorders, attention deficit, and learning disorders. This review determines to what extent behavioral disorders in an economically disadvantaged population coincide with Epilepsy. Outcomes could improve conduct, learning , and behavior through early Epilepsy evaluations and treatment. Eighty three patients, ages four to seventeen, 60% female and 40% male, received a psychosocial evaluation, followed by psychological and neuropsychological testing, neurological exam, and electroencepholograms in four scheduled visits. The results are summarized in a round table discussion with the team composed of the social worker, psychologist, nurse practitioner, neurologist, and psychiatrist. Recommendations and results are presented to the patient and the patient support team with the patient present.
The following tests are performed when indicated and appropriate: 1)A psychosocial evaluation consisting of social , medical, and psychiatric histories, [amp] caretaker self administered child behavioral evaluation through the computerized Behavioral Assessment Scale for Children.(BASC). 2) The child or adolescent concurrently was tested for general intelligence and memory, utilizing the Weschler Intelligence Scale, and memory testing with the Children Memory Scale or Weschler Memory Scale. In addition, the following instruments can be utilized: Stroop Color Word Test, Wide Range Achievement Test, Personality Assessment Inventory, and Rorschak projective testing. A subsequent session includes the Halstead-Reitan Neuropsychological Test Battery. An EEG(a,d,s,hv[amp]p and imaging when pertinent) was adminsistered, and neurological examination. Twelve of eighty three (14.5%) patients had abnormal EEGs in the testing group. Of the twelve patients with abnormal EEGs, 90% were classified as Oppositional Defiant Disorders, 50% ADD-ADHD, and 10% others (Aspergers and Psychosis). Four of these patients reported seizures while being tested. Historically, seven patients reported staring spells or impairment of consciousness, or typical seizure manifestations. 60% of the EEGs had generalized spike and wave, 25% were localized, and 15 % had 3/sec S[amp]W. The results suggest that one in seven have abnormal EEGs associated with behavioral disorders, or Epilepsy, or both. These findings suggest that all patients referred for behavioral, psycholgical, and neuropsycholgical testing by a Community Mental Health Agency should be evaluated for Epilepsy.