Cognitive function, mood, behavioral aspects, and personality traits of adult males with idiopathic epilepsy

Abstract

Objective

This study was designed to assess cognitive function, mood, aggression, and personality traits among adult men with idiopathic epilepsy.

Methods

Seventy-one male patients with idiopathic epilepsy were recruited from the outpatient epilepsy clinic of Assuit University hospitals. Another 58 subjects matched with respect to age, sex, and socioeconomic status formed the control group. For each participant, a complete medical history was obtained, and clinical examination, EEG, and psychometric evaluation were performed. For the psychometric evaluation, we used the Stanford–Binet test (fourth edition) to assess cognitive function, the Beck Depression Inventory to assess symptoms of depression, the Aggressive Behavior Scale, and the Eysenck Personality Questionnaire.

Results

Patients with epilepsy reported highly significant impairment in all cognitive measures and higher scores on depressive symptoms, aggressive behavior, and most personality traits compared with controls. Early age at onset, prolonged duration of illness, increased frequency of seizures, and history of status epilepticus were significantly negatively correlated with some of the cognitive function subscales.

Conclusion

Epilepsy itself and epilepsy-related factors are associated with cognitive function deterioration, depression, aggression, and some abnormal personality traits.

Introduction

Epilepsy is a biomedical disturbance that results in abnormal episodic bursts of electrical activity in certain neurons, which have significant impact on the normal cognitive processes and behavior of the affected individuals [1]. Idiopathic epilepsies are subclassified as “generalized,” which means that ictal and interictal EEG correlates of these epilepsies cover the entire neocortex [2], and “partial” or “focal,” which are caused by a disorder of the neurons in a specific site on one side of the brain [3]. Generalized seizures may result in nerve cell disturbances that can affect more diffuse areas of the brain than do partial seizures [4].

In the few studies on neuropsychological testing of people with idiopathic epilepsies, patients do worse than healthy people on some tasks [2]. Davidson et al. reported that children with idiopathic generalized epilepsy exhibit accelerated forgetting of verbal and nonverbal information in comparison to healthy controls matched for age and IQ [5]. Blake et al. reported that an active temporal lobe epileptic focus is sufficient for accelerated long-term forgetting of verbal material [6].

A number of behavioral/emotional syndromes appear to be common among patients with epilepsy, although prevalence estimates tend to vary widely across studies. The occurrence of behavioral abnormalities and cognitive dysfunction can be driven by a variety of psychosocial and seizure-related factors [7]. Common behavioral/emotional syndromes seen in patients with epilepsy include depression, anxiety, psychosis, attention deficit, and aggression [8], [9], [10], [11], [12]. A variety of psychosocial problems associated with epilepsy can exacerbate cognitive and behavioral dysfunction [13]. Episodic emotional changes such as fear, anxiety, and aggression may also occur in association with seizure discharges [14].

Our goal was to determine if epilepsy itself (generalized vs focal) has effects on cognition, behavior, mood, and personality traits in adult males with idiopathic epilepsy.