Abstracts

Rationale: There is evidence of psychiatric and personality disorders related to impairment in impulse control in patients with Juvenile Myoclonic Epilepsy (JME). These patients are usually studied as a homogeneous group with similar characteristics. However, some of these patients’ seizures are harder to control and, even with higher doses of AED, myoclonic seizures may occur. The objective of the present study was to investigate the correlation between epilepsy clinical variables and the presence of impaired impulse control. Methods: Forty patients (26 years ±8.1; IQ 90±9,2) with a diagnosis of JME and 22 controls (27 years ± 9,1; IQ 96± 6,15) were evaluated using the temperament dimension “Novelty Seeking” (NS) of the Temperament and Character Inventory (TCI) of Cloninger, validated for the portuguese language. TCI provides quantitative measures of traits of personality and, Novelty Seeking dimension provides measures of impulsive personality behaviors. Epilepsy clinical variables were: 1. seizure frequency (GTC and myoclonic); 2. epilepsy duration; 3. age of onset and; 4. seizure control and refractoriness. Patients with JME were divided into two groups considering seizure control and refractoriness and were classified in group I (n=30) and group II (poor seizure control n=10). We used the Student's "t" test to compare JME patients and controls and, JME groups on Novelty Seeking scores. Results: The group of patients with JME had higher scores in Novelty Seeking dimension compared to the control group [p=0.001]. The JME group 2 showed significantly higher scores [p=0.001] on NS temperament dimension of TCI when compared with JME group 1. Patients with high seizure frequency also showed higher scores on NS [p=0.029]. Conclusions: Patients with JME have higher expression of impulsive traits compared to controls. Moreover we also observed that patients with unsatisfactory seizure control and elevated seizure frequency have higher scores in novelty seeking dimension, demonstrating that this group of patients present even worse impulse control. The study of personality traits in JME must take into account clinical differences since we may be facing two different clinical phenotypes in patients with JME. Supported by FAPESP.