Higher levels of impulsivity and depression are present in patients with temporal and extra- temporal focal epilepsy

Abstract

Purpose: To analyze patients with clearly and defined focal epilepsy from temporal (ELT) and extra-temporal lobe origin (ETE), and a control group, and to compare the prevalence of psychiatric comorbid disorders and the levels of impulsivity between them. Methods: Consecutive patients who met criteria of drug-resistant focal epilepsy of temporal and/or extra-temporal origin, clearly defined and confirmed by VEEG (Video-EEG), were included. Psychiatric assessment was conducted using the Structured Clinical Interview for Axis I and II diagnose of DSM-IV (SCID I-II), the Barrat-11 scale for measure impulsivity, and Beck inventory for depression. Results: 73 patients with drug-resistant temporal lobe epilepsy (TLE), 21 with extra-temporal focal epilepsy (ETE) and 58 healthy control subjects were included. A total of 45 patients (61.6%) in TLE group and 13 patients (61.9%) in ETE group met criteria for at least one present or past psychiatry disorder coded on Axis I of DSM-IV. Both ELT and ETE groups presented higher Barrat-11 scores compared to the control group (p<0.01). ETE showed a tendency to a higher impulsivity level, particularly in the motor factor compared to ELT (p=0.05). A left laterality of the epileptogenic zone, and the presence of psychiatric disorders (depression) were associated with higher impulsivity among patients with ELT (p<0.05). Conclusion: Impulsivity and psychiatric comorbidity are important issues to consider in clinical evaluation of patients with drug-resistant focal epilepsies. The evaluation by an adequately mental health team should be considered routine among these patients.