Abstracts

Rationale: There are evidences that most neuropsychological tests are inadequate in assessing executive functions, because as component tests, they may not be sufficient to capture more complex everyday executive problem-solving deficits. In adults with temporal lobe epilepsy (TLE) the presence of executive dysfunction is well described, although there are controversies about the presence of this dysfunction when those patients were evaluated with the Wisconsin Card Sorting Test (WCST). For that reason, we aimed to identify, from a neuropsychological battery of eight executive functions tests for children, those that might be better to discriminate executive dysfunction in children with TLE. Methods: Thirty-one children with TLE were evaluated and their performance on a neuropsychological battery was compared to 21 healthy volunteers with no history of neurological or psychiatric disorders, matched as to age, sociodemographic and educational background to the subjects of the study. Results: Our findings suggest worse performance of TLE patients in: WCST, Digit Forward; Matching Familiar Figures Test; Trail Making Test; Word Fluency (animals); Finger Window and Number and Letter (WRAML). Twenty-five patients (80.64%) had worse performance in WCST compared to controls by clinical criteria. Thirty patients (96.77%) had a bad performance in at least one executive test, other than WCST. Five out of 6 patients (83.33%) who presented a good performance in WCST had a bad performance in other tests.Conclusions: We observed that although 80.64% of TLE patients had a bad performance in WCST, that number increased to 96.77% when considering other executive function tests. These findings point to an executive dysfunction in children with TLE that could not be sufficiently measured by the WCST, leading to an underdiagnosis of the dysfunction per se and of its impact on daily life activities.