REVIEW – August 2004

Behavioural phenotype of frontal lobe epilepsy in children

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Abstract

Frontal lobe epilepsy is the second most frequent focal epilepsy after temporal lobe epilepsy. Several studies have demonstrated a relationship between frontal lobe damage and behavioural disturbances in non epileptic patients. Literature data of the psychopathology of children with frontal lobe epilepsy are scarce. The aim of this study was to find out the neuropsychological and psychopathological features of frontal lobe epilepsy in children aged 7 to 12 years. Methods and patients. Frontal lobe epilepsy was diagnosed by a paediatric neurologist on the basis of the clinical picture of seizures and the findings of EEG. For establishment of psychopathology,a paediatric psychiatrist and a paediatric neuropsychologist investigated all 15 cases. Achenbach’s Child Behavior Checklist (CBCL) for Parents and Kaufman Assessment Battery for Children (K-ABC) were used for the establishment of psychiatric disturbances and for the assessment of mental development. Results. Learning disabilities were established in 12/15 of the cases. K-ABC showed that mental processing composite (MPC) was below average. There was higher probability for a disturbance of Simultaneous Processing compared with Sequential Processing. The results of the CBCL Internalizing Scale revealed problems in 12/15 of the children with frontal lobe epilepsy. The externalizing Scales (delinquent; aggressive behaviour) demonstrated abnormalities in 7/15 of the cases. The most prominent problems were avoidant behaviour and somatic complaints (different pains with negative investigation results); social problems, thought problems and attention problems occurred in half of the cases. Conclusions. The mental abilities of the children with frontal lobe epilepsy were lower than average. Simultaneous Processing was more affected. Internalizing behavioural syndromes were more prominent than externalizing behavioural syndromes.