Neuropsychological profile of patients with juvenile myoclonic epilepsy: A controlled study of 50 patients

The purpose of this study was to verify possible cognitive dysfunction in patients with juvenile myoclonic epilepsy (JME) and its relationship to factors related to epilepsy and schooling. Fifty subjects diagnosed with JME and 50 controls underwent neuropsychological assessment evaluating intellectual functions, attention, memory, executive functions, and language. The patients were further divided into two subgroups on the basis of educational level: < or = 11 and >11 years of formal education. Participants diagnosed with JME scored significantly below age-, education-, and gender-matched controls on neuropsychological measures of attention, immediate verbal memory, mental flexibility, control of inhibition, working memory, processing speed, verbal delayed memory, visual delayed memory, naming, and verbal fluency. A positive correlation was observed between duration of epilepsy and cognitive decline. However, in the group of patients with >11 years of education, this correlation was not significant. In this series of patients with JME, neuropsychological evaluation suggests widespread cognitive dysfunction outside the limits of the frontal lobes. The duration of epilepsy correlated with cognitive decline, and patients with higher education manifested less progression of deficits.

[1]  O. Devinsky,et al.  Frontal functions in juvenile myoclonic epilepsy. , 1997, Neuropsychiatry, neuropsychology, and behavioral neurology.

[2]  I Savic,et al.  MRS shows syndrome differentiated metabolite changes in human-generalized epilepsies , 2004, NeuroImage.

[3]  Li Min Li,et al.  Voxel-based morphometry in patients with idiopathic generalized epilepsies , 2006, NeuroImage.

[4]  O. Spreen,et al.  A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary , 1991 .

[5]  Maryse Lassonde,et al.  Idiopathic epileptic syndromes and cognition , 2006, Neuroscience & Biobehavioral Reviews.

[6]  A. Aldenkamp Effect of Seizures and Epileptiform Discharges on Cognitive Function , 1997, Epilepsia.

[7]  M J Koepp,et al.  Juvenile myoclonic epilepsy – a generalized epilepsy syndrome? , 2005, Acta neurologica Scandinavica. Supplementum.

[8]  I Savic,et al.  MR Spectroscopy Shows Reduced Frontal Lobe Concentrations of N‐Acetyl Aspartate in Patients with Juvenile Myoclonic Epilepsy , 2000, Epilepsia.

[9]  D. Janz,et al.  Neuropathological Findings in Primary Generalized Epilepsy: A Study of Eight Cases , 1984, Epilepsia.

[10]  Jorge Eslava‐Cobos,et al.  Experience with the International League Against Epilepsy Proposals for Classification of Epileptic Seizures and the Epilepsies and Epileptic Syndromes in a Pediatric Outpatient Epilepsy Clinic , 1989, Epilepsia.

[11]  S L Free,et al.  Quantitative MRI in patients with idiopathic generalized epilepsy. Evidence of widespread cerebral structural changes. , 1997, Brain : a journal of neurology.

[12]  J. Overweg,et al.  Neuropsychological Aspects of Learning Disabilities in Epilepsy , 1990, Epilepsia.

[13]  M. Lezak Neuropsychological assessment, 3rd ed. , 1995 .

[14]  O. Devinsky,et al.  Adult‐Onset Idiopathic Generalized Epilepsy: Clinical and Behavioral Features , 2001, Epilepsia.

[15]  T. Serikawa,et al.  Long‐Term Effects of Continual Intake of Phenobarbital on the Spontaneously Epileptic Rat , 1990, Epilepsia.

[16]  P. Rutecki,et al.  The nature and course of neuropsychological morbidity in chronic temporal lobe epilepsy , 2004, Neurology.

[17]  C. Dodrill,et al.  Neuropsychological Abilities of Children with Epilepsy , 1985, Epilepsia.

[18]  C. Dodrill,et al.  Neuropsychological Abilities Before and After 5 Years of Stable Antiepileptic Drug Therapy , 1992, Epilepsia.

[19]  D. Mandelbaum,et al.  The effect of seizure type and medication on cognitive and behavioral functioning in children with idiopathic epilepsy , 1997, Developmental medicine and child neurology.

[20]  S. Benbadis,et al.  Epileptic seizures and syndromes. , 2001, Neurologic clinics.

[21]  F. Woermann,et al.  Abnormal cerebral structure in juvenile myoclonic epilepsy demonstrated with voxel-based analysis of MRI. , 1999, Brain : a journal of neurology.

[22]  B E Swartz,et al.  Visual working memory in primary generalized epilepsy , 1996, Neurology.

[23]  I. Wilkinson,et al.  Idiopathic generalised epilepsy: a pilot study of memory and neuronal dysfunction in the temporal lobes, assessed by magnetic resonance spectroscopy , 2006, Journal of Neurology, Neurosurgery & Psychiatry.

[24]  L L Bailet,et al.  The Impact of Childhood Epilepsy on Neurocognitive and Behavioral Performance: A Prospective Longitudinal Study , 2000, Epilepsia.

[25]  D. Ataklı,et al.  Cognitive function in juvenile myoclonic epilepsy , 2004, Epilepsy & Behavior.