Abstracts

Rationale: Rolandic epilepsy (RE) and Temporal Lobe Epilepsy (TLE) represent two distinct models of localization-related epilepsy of childhood. In both, there is evidence of executive dysfunction. The purpose of the present study was to identify particular deficits in executive function that would distinguish children with rolandic epilepsy from children with temporal lobe epilepsy. Methods: We prospectively evaluated 19 consecutive children and adolescents with TLE-HS (57.9% male; mean 11.74 years [SD 2.05]; mean IQ 95.21 [SD 15.09]), 19 with RE (36.8% male; mean 10.95 years [SD 2.33]; mean IQ 101.75 [SD 15.08]), and 21 controls (33.3% male; mean 11.86 years [SD 2.25]; mean IQ 108.67 [15.05]). All participants (with and without epilepsy) underwent a neuropsychological assessment with a comprehensive battery for executive and attentional functions. Intellectual functioning was estimated based on two subtests from WISC. Neuropsychological battery was composed by: Digits Forward and Backward, Windows Fingers test, Wisconsin Card Sorting Test (WCST),Trail Making Test, Matching Familiar Figures Test and Semantic verbal fluency test. We used ANOVA and chi-square to evaluate differences on demographic aspects among groups (RE, TLE-HS and control groups). Group comparisons on continuous variables were complemented by MANOVA and Tukey HSD post-hoc comparisons. Results: Patients with RE and TLE were impaired relative to healthy children on tests assessing attention and executive functions (Table). Compared to controls, patients with TLE-HS had worse performance in number of categories achieved (p < 0.001) and number of perseverative errors (p < 0.001) in WCST , MFFT time X errors (p < 0.001) and Verbal Fluency for Foods (p = 0.001). Patients with RE had worse performance than controls in: number of categories achieved in WCST (p < 0.001), Verbal Fluency for Food (p = 0.001), MFFT time (p < 0.001), MFFT time X errors (p < 0.001), TMB time (p = 0.005) and TMB errors (p = 0.018). Patients with TLE showed worse performance than children with RE on the following subtests: perseverative errors in WCST (p < 0.001) and Digit Backward (p < 0.001). Children with RE had a worse performance on MFFT time (p < 0.001) compared to TLE-HS. Conclusions: Patients with TLE and RE were impaired relative to healthy children on tests assessing executive functions, corroborating previous studies. However, they present distinct cognitive profiles considering these deficits. Compared to children with RE, patients with TLE had impairment in mental flexibility and working memory. On the other hand, patients with RE showed worse performance than controls on selective attention, that remained significant even when compared with patients with TLE. Rehabilitation programs for children with epilepsy must include children with benign epilepsies and must take into account the epileptic syndrome and its particular neurocognitive phenotype. Funding: FAPESP & CNPq