Abstracts

Rationale: Based on discussions of the of the so called "epileptic personality" in epilepsy patients, interictal behavioural impairments in frontal and temporal lobe epilepsies were examined in a multivariate approach which took subject variables, clinical and neuropsychological determinants into consideration. Methods: A total of 428 patients epilepsies originating from the temporal (84%) or frontal (16%) lobes were examined in regard to personality (FPZ personality questionnaire) and mood (BDI I). Prevalence of impaired behavioural domains was determined. Etiologically relevant determinants of behavioural problems were identified via multiple regression analyses. Results: Elevated depression scores (BDI) were evident in 38% of the patients, and not different in TLE and FLE. As for personality, introversion, poorer mood, sociability, and self-determination as well as problems with interpersonal communication were frequent. The TLE group tended to show greater neuroticism and introversion, while FLE appeared more associated with aspects of an organic psycho-syndrome. Multivariate analyses indicate demographic (age, gender, education), clinical aspects (psychiatric history, affected hemisphere, mesial pathology, seizure frequency, cognitive functions), and treatment (antiepileptic drugs) as relevant determinants, explaining, however, maximally 30% of the behaviour. Conclusions: Behavioural abnormalities in patients with frontal or temporal lobe epilepsy are common but mostly mild. Within a multivariate etiological model, localization (mesial yes/no) and lateralization (left >right) dependent behavioural problems in TLE and FLE are overshadowed by other variables, of which patients and their families psychiatric history, person variables and pharmacological treatment are of major importance. Education and cognitive capabilities may be discussed as protective features.