Abstracts

Rationale: Mild Neuropsychological deficits related to posterior brain regions have been reported in patients with benign epilepsy with centrotemporal spikes (BECTS), mostly referred from tertiary care centers. The aim of this study is to evaluate neuropsychological functions in children from community with BECTS with new onset seizures (< 2yrs). Methods: Twelve children with BECTS (ILAE,1989) were studied from Hospital Universitário of the University of Sao Paulo, a secondary care regionalized facility located in a district of middle-low income in Sao Paulo city, Brazil. All families signed an informed consent and the children performed neurological, EEG and neuropsychological evaluation which consisted of Raven’s Special Progressive Matrices, Wechsler Children Intelligence Scale-WISC III, ACID Profile in WISC III, Trail Making Test A/B, Stroop Test, Bender Visuo-Motor Test, Rey Complex Figure, Rey Auditory Verbal Learning Test-RAVLT, Boston Naming Test, Fluency Verbal for phonological and also conceptual patterns-FAS/Animals and Hooper Visual Organization Test. For academic achievement, we used a Brazilian test named “Teste do Desempenho Escolar”, which evaluates abilities to read, write and calculate according to school grade. Results: There were 10 boys and 2 girls, with ages ranging from 7.5 - 14yrs. All were literate and attended regular schools. All children scored in a median/ superior range for IQ, but all, showed higher scores for the verbal subtest, and half of them a discrepancy difference of more than 20 points when compared with the performance subtest. There were low scores for attention in different modalities, mainly in inhibitory attention as well as for evocative memory to learn facts (Information subtest-WISC-III). Executive functions showed qualitative deficits in activity planning, mostly observed in Rey Complex Figure copy and in WISC III Maze Test. Reading and writing skills were bellow average for school grade in 8 and 11 patients, respectively. Conclusions: Although posterior deficits such agnosic auditory and visual deficits have been described in children with BECTS, we observed in these children from community more anterior neuropsychological dysfunctions including those from executive area. This probably reflects the role of frontal areas that may be involved in the circuitry of the epileptic process in these children, explaining also the attention deficits described in this sample, which may be overlapped in more severe cases seen in tertiary centers. These findings suggest that even in this prototype type of focal idiopathic epilepsy there may be present diffuse dysfunctions probably caused by an underlying generalized dysmaturational epileptogenic process.