Abstracts

The complex relationship between temporal lobe epilepsy (TLE) and psychiatric disorders (PD) has been matter of interest, and important studies have emphasized this association. PD compromise patients[apos] quality of life. Few studies, however, studied the frequency of PD in patients presenting the same etiology of TLE. We evaluated the frequency of PD in a homogenous series of patients with refractory TLE related to mesial temporal sclerosis (MTS) aiming to determine the frequency of PD and possible correlations with clinical variables as well as laterality and degree of atrophy in volumetric MRI measures., Data from 106 patients with refractory TLE related to MTS accompanied at the outpatient epilepsy clinic of Universidade Federal de S[atilde]o Paulo, Brazil, from March 2005 to May 2006 were reviewed. The psychiatric evaluation was based on axis I DSM-IV criteria and on Bear and Fedio Inventory[italic] [/italic](BFI). For statistical analysis, the [italic]X[sup2] [/italic]test and Student[apos]s T test were used. P value considered significant was [lt] 0.05., Sixty-one females and 45 males were evaluated. The mean age and mean duration of the disease were 39.5[plusmn]13.4 and 24[plusmn]11.3 years, respectively. The mean age at epilepsy onset was 19.0[plusmn]12.8 years. MTS occurred more frequently on left side (72 cases; 68%), followed by right side (30 cases; 28.3%) and by 4 cases of bilateral MTS (3.7%). The hippocampus were significantly smaller (p[lt]0.05) in the side of the epileptogenic zone. Carbamazepine and phenytoin were the most used single drugs, and their association to a benzodiazepine, mostly clobazam, the most common association. PD were found in 65 patients (61.3%). Humor disorders were the most frequent (32 cases; 30%), followed by interictal (15 cases; 14%) and postictal (10 cases; 9.4%) psychosis. Twelve patients performed criteria for 2 axis I disorders, and the most frequently found association was major depression and postictal psychosis (7 cases), related to left MTS. Postictal and interictal psychosis were significantly associated with left side (p[lt]0.05), while PD in general and humor disorders were not associated to any side., There was a high prevalence of PD in patients with refractory TLE associated to MTS. The most common were humor and psychotic disorders. Psychosis was significantly associated to left side. These findings are concordant with data in current literature relating the prevalence of PD in TLE, confirming the existence of anatomic alterations, and also a possible left laterality effect in the mesial temporal lobe structures in patients with epileptic psychosis., (Supported by CAPES and FAPESP from Brazil.)