Avaliação neuropsicológica em portadores de epilepsia do lobo temporal

Abstract

A epilepsia é caracterizada como sintoma ou sinal subjacente a uma desordem neurológica nem sempre identificada, manifesta por breves descargas elé-tricas neuronais, decorrentes de distúrbios nas funções elétricas cerebrais 1 . Estas manifestações produzem crises súbitas e rápidas em intervalos ocasionais e causam diferentes conseqüências neurológicas, entre elas, a disfunção cognitiva 2 . As crises classificadas como parciais complexas, originadas no lobo temporal, têm sido associadas a distúrbios de memória de curto e de longo prazo 3,4 ; provavelmente, estes distúrbios decorram de lesões e da redução do volume hipocampal, no entanto, nem todos os pacientes que sofrem as crises parciais complexas apresentam lesões. Estruturalmente estas lesões são identificáveis por meio de neuroimagem e funcionalmente pelos resultados da avaliação neuropsicológica [5][6][7][8] . Assim, determinadas manifestações comportamentais do indivíduo podem ser investigadas e mensuradas a partir de testes neuropsicológicos 9 . Classicamente, estes instrumentos simulam ou reproduzem uma situação em laboratório para quantificar e descrever qualitativamente as respostas obtidas, mas o procedimento pode afastar a situação do real, tornando-a mais improvável de ocorrer na vida diária do sujeito 10 . O teste ecológico comportamental de memória de Rivermead (TCMR) é muito utilizado [11][12][13][14][15] , no entanto, a literatura carece de dados do TCMR na avaliação da epilepsia de lobo temporal.O presente estudo tem como objetivo avaliar a cognição, principalmente memória, de pacientes com e sem lesão no lobo temporal mesial, por meio de tes- PAlAvRAs-ChAvE: epilepsia, cognição, teste comportamental de memória de Rivermead. Neuropsychological assessment in patients with temporal lobe epilepsyAbsTRACT -We investigated the patient cognition with temporal lobe epilepsy that presented or no mesial injury in magnetic resonance exam. We used classics and ecological neuropsychological tests to indicate possible functional alterations, and to compare results between ecological and traditional instruments. Thirty-four people match in age and study year were separate in three groups: 12 patients with mesial injury; 12 without injury and 10 health people. We used for functional evaluation: Wechsler adult intelligence and memory scales subtests, verbal fluency and Rivermead behavior memory test. The patients with injuries presented low cognitive performance when compared with control groups in various tasks: attentional span, memory, speech, daily problems resolution, while the patients without injury showed more compensated with mild attentional alterations. both traditional memory tests and ecological memory tests were efficient to describe the cognitive profile of patients with epilepsy.KEy WORds: epilepsy, cognition, Rivermead behavior memory test.hospital universitário da universidade Federal de sergipe, Aracaju sE, brasil:

Comparison of screening tests in the evaluation of cognitive status of patients with epilepsy

“…In this study, the addition of 1 point was maintained for those patients with less than 12 years of schooling. 7,11 The results of quantitative variables were described by means, standard deviations, medians, and minimum and maximum values, while the categorical variables were described by frequencies and percentages. The non-parametric Mann-Whitney test was performed to compare two groups regarding the discrete quantitative variables.…”

“…5 Additionally, in a study with a series of neuropsychological tests with the aim of assessing both memory and psychomotor skills, about 53% of newly diagnosed and untreated epileptic patients had at least abnormal test scores in comparison to the mean of the control group. 7 Neuropsychological evaluation is mandatory in the follow-up of patients with this condition, due to their cognition declines, 8 which, in most cases, cause a deficit in reasoning, memory and attention. It also occurs due to functional and morphological changes caused by the seizures, 9 in association with injuries, aging and progressive brain damage.…”