Abstracts

RATIONALE: Epileptic patients (pts) have a larger risk of psychiatric problems than general population; 10 to 30% of patients with temporal lobe epilepsy (TLE) have psychotic symptoms. SPECT, has been highlighted as an important neuroimaging resource in the evaluation of neuropsychiatric disorders.This study describes interictal SPECT findings in epileptic patients with TLE, comparing a group with psychotic and a group without psychotic disorders. METHODS: Two groups were studied. Group I with 7 pts showing Interictal Psychosis (IP), and Group II with 10 pts with no Interictal Psychosis (NIP). The following regions were analyzed: basal ganglia, cingulate gyrus, frontal and temporal lobes. It was sought the comparison of the following variables: gender, age, schooling, seizure type, laterality, age at the beginning of the seizures and beginning of the psychosis. All the subjects were previously submitted to psychiatric evaluation (based on DSM-IV 4th Ed). RESULTS: IP / NIP groups presented, respectively, the following averages: Age: 38 / 34 years; scholarity: 4,8 / 7,1 years; age of seizures onset: 7,0 / 10,8 years; age at the beginning of the psychosis: 27 years. Gender: IP: 4 M / 3 F; NIP: 3 M / 7 F. Laterality of epileptogenic zone: IP group: 4 pts sided to the right, 3 pts to the left. NIP group: 5 pts sided to the right, and the other ones 5 to the left. Main SPECT findings: 4 IP pts and only 1 NIP pts presented cerebral blood hiperperfusion in cingulate gyrus. Temporal hipoperfusion in 3 IP pts and 9 NIP pts. Perfusion differences in the frontal and basal banglia areas were not observed in this study. CONCLUSIONS: Although the size of the sample is small, this interictal study seems to show a tendency of IP pts to present higher perfusion in the cingulate area and lower perfusion in the temporal lobe, when compared to NIP pts.