Abstracts

Cognitive decline in temporal lobe epilepsy (TLE) is a major contributor to the burden of the disorder, extending beyond memory dysfunction ¹. Higher educational level may be a protective factor against cognitive decline ². We analyzed the cognitive deficits and the relationship between cognitive decline and duration of epilepsy in patients with TLE due to unilateral HS. As a secondary objective we studied the impact of educational level on cognitive decline., This retrospective study involved 60 outpatients and 60 healthy controls subjects. All patients had diagnosis of TLE due to unilateral HS and were submitted to neuropsychological assessment and high-resolution MRI. Neuropsychological results were compared with a control group, paired according to age, gender and educational level. An impairment index was calculated to indicate the individual impairment in each patient (percentage of results considered abnormal). Patients were divided in two separate groups ([le] 8 years of formal education and [gt] 8 years)., The 60 patients (62.3% women) had a mean age of 38.1 years and a mean duration of epilepsy of 29 years. Mean age of onset was 8.7 years. Patients had lower IQ when compared to control subjects. TLE patients showed worse performance in the following neuropsychological tests: Category Fluency (Animals), Boston Naming Test; Rey Complex Figure (delayed recall administrations); Vocabulary, Block Design, Digit Span and Logical Memory I e II . Cognitive decline (indicated by the impairment index) was correlated to duration of epilepsy (r=0.285, p=0.026). When we analysed separately the group of patients with higher educational level ([gt] 8 years) the correlation between cogntive decline and duration of epilepsy was also observed (r = 0.520, p= 0.016)., Patients showed cognitive deficits that included impairment in language, visuospatial constructional ability, and in verbal and visual memory. These deficits correlated to duration of epilepsy, supporting the hypothesis of progression in TLE. Higher educational level did not protect against this decline in this homogeneous population of patients with unilateral HS.

Oyegbile TO, Dow C, Jones J et al. The nature course of neuropsychological morbility in chronic temporal lobe epilepsy. Neurology. 2004; 62: 1736-1742.
Dodrill CB. Progressive cognitive decline in adolescents and adults with epilepsy. Prog Brain Res 2002; 135: 399[ndash]407., (Supported by FAPESP (Funda[ccedil][atilde]o de Amparo [agrave] Pesquisa do Estado de S[atilde]o Paulo) and CAPES (Coordena[ccedil][atilde]o de Aperfei[ccedil]oamento de Pessoal de N[iacute]vel Superior)/CNPq (Conselho Nacional de Desenvolvimento Cient[iacute]fico e Tecnol[oacute]gico).)