Abstracts

Rationale: Juvenile Myoclonic Epilepsy (JME) is the most common idiopathic generalized epilepsy. Neuropsychological studies in patients with JME show cognitive deficits, mainly in executive functions. There is scarce data on the importance of clinical variables and the executive impairment detected in these patients. This study aimed to correlate the neuropsychological evaluation as to executive and attentional functions with the clinical profile in a group of patients with JME. Methods: In this prospective study, 40 patients (26 years ±8.1; IQ 90±9,2) with a diagnosis of JME were evaluated by applying a neuropsychological battery of tests made up by: Digit Span, Stroop Color Test (SCT), Trail Making Test (TMT), Wisconsin Card Sorting Test (WCST), Verbal Fluency (FAS), Matching Familiar Figures Test (MFFT), Matrix Reasoning (MR), and Vocabulary from WASI. Epilepsy clinical variables were: 1. seizure frequency (GTC and myoclonic); 2. epilepsy duration; 3. age of onset and; 4. seizure control and refractoriness. Patients with JME were divided in two groups considering seizure control and refractoriness and were classified into group I (n=30) and group II (poor seizure control n=10). We used the Student's "t" test to compared groups on neuropsychological tests. Results: Patients of group 2 had significantly impaired performance in the following neuropsychological tests: Digit Forward (p=0.004); Digit Backfoward (p=0.041), SCT1(p=0.006); SCT2 (p=0.002); SCT3 (p=0.001); TMT-A (p=0.001); FAS (p=0.007); WCST categories (p=0.002); WCST number of errors (p=0.001); WCST perseverative answers (p=0.034); WCST set losses (p=0.001); MFFT errors (p=0.001) and MFFT latency (p=0.017) in comparison with patients of group 1. Moreover, age of onset and epilepsy duration have a significant correlation with Digit Forward (p=0.005) and MFFT errors (p=0.035) tests. Conclusions: Patients with unsatisfactory seizure control have worse performance in distinct domains of executive and attentional functions such as attention span, working memory, concept formation, mental flexibility, inhibitory response control, verbal fluency, and maintenance of goals. Other clinical variables such as age of onset and epilepsy duration had a minor impact in executive function considering the number of tests.