RESUMO
Our aim was to clarify the correlation of attention deficit hyperactivity disorder (ADHD) with epilepsy and behavior problems. This was a cross-sectional study. Sixty children with idiopathic epilepsy were interviewed using the MTA-SNAP IV Teacher and Parent Rating Scale, Vineland Adaptive Behavior Scales and Conners' Rating Scales. We used the chi-square test to analyze the correlation of epilepsy variables in patients with and without ADHD with a significance level of 0.05. Eight patients had ADHD symptoms (13%), seven had the inattentive ADHD subtype and only three had behavioral problems. When epileptic patients with and without ADHD symptoms were compared we found no significant difference in regard to epilepsy variables. All patients were controlled and 43% were either without AED or undergoing withdrawal. Our study revealed a low comorbidity of ADHD symptoms and epilepsy due to low interference of seizures and drug treatment on the comorbid condition.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Epilepsia/fisiopatologia , Adolescente , Idade de Início , Anticonvulsivantes/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Comportamento/fisiologia , Distribuição de Qui-Quadrado , Criança , Comorbidade , Estudos Transversais , Epilepsia/tratamento farmacológico , Epilepsia/epidemiologia , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Valores de Referência , Fatores de TempoRESUMO
Our aim was to clarify the correlation of attention deficit hyperactivity disorder (ADHD) with epilepsy and behavior problems. This was a cross-sectional study. Sixty children with idiopathic epilepsy were interviewed using the MTA-SNAP IV Teacher and Parent Rating Scale, Vineland Adaptive Behavior Scales and Conners’ Rating Scales. We used the chi-square test to analyze the correlation of epilepsy variables in patients with and without ADHD with a significance level of 0.05. Eight patients had ADHD symptoms (13%), seven had the inattentive ADHD subtype and only three had behavioral problems. When epileptic patients with and without ADHD symptoms were compared we found no significant difference in regard to epilepsy variables. All patients were controlled and 43% were either without AED or undergoing withdrawal. Our study revealed a low comorbidity of ADHD symptoms and epilepsy due to low interference of seizures and drug treatment on the comorbid condition.
Nosso objetivo foi clarificar a correlação entre transtorno do déficit de atenção (TDAH) com epilepsia e problemas comportamentais. Este foi um estudo transversal. Sessenta crianças com epilepsia idiopática foram entrevistadas com a Escala para Pais e Professores MTA-SNAP IV, Escala de Comportamento Adaptativo Vineland e Escala Conners. Utilizamos o teste do qui-quadrado para analisar a correlação das variáveis de epilepsia em pacientes com e sem TDAH com um nível de significância de 0,05. Oito pacientes apresentaram sintomas de TDAH (13%), sete tiveram o subtipo inatento e três deles tinham problemas comportamentais. Quando os pacientes epilépticos com e sem TDAH foram comparados, não encontramos diferença significativa em relação às variáveis de epilepsia. Todos os pacientes estavam controlados e 43% deles estavam sem medicação ou em retirada da droga. O nosso estudo mostrou baixa comorbidade entre epilepsia e TDAH devido à baixa interferência de crises e tratamento na condição comórbida.
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Epilepsia/fisiopatologia , Idade de Início , Anticonvulsivantes/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Comportamento/fisiologia , Distribuição de Qui-Quadrado , Comorbidade , Estudos Transversais , Epilepsia/tratamento farmacológico , Epilepsia/epidemiologia , Escalas de Graduação Psiquiátrica , Valores de Referência , Fatores de TempoRESUMO
Rolandic epilepsy (RE) is the most common type of childhood focal epilepsy. Although there is no intellectual deficit, children with RE may have specific cognitive impairments. The aims of this study were to identify changes in executive functions in children with RE and to verify the influence of epilepsy and seizure variables. We evaluated 25 children with RE and 28 healthy controls. A comprehensive neuropsychological battery was utilized. The results showed that the RE children had worse performance than the control group in some categories of the Wisconsin Card Sorting Test, the Trail Making Test part B, and the Verbal Fluency Test (FAS). Children with earlier onset of epilepsy had worse performance when compared with children with later onset of epilepsy. We conclude that children with RE may show a deficit in executive function despite their normal IQ. The set of tests was more extensive than what was previously used in other studies. Our study suggests that early seizures can interfere with brain development. Regarding cognition, the term benign should be used cautiously in RE.
Assuntos
Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/etiologia , Epilepsia Rolândica/complicações , Função Executiva/fisiologia , Testes Neuropsicológicos , Criança , Epilepsia Rolândica/psicologia , Feminino , Humanos , Masculino , Índice de Gravidade de Doença , Estatística como AssuntoRESUMO
PURPOSE: Landau-Kleffner syndrome (LKS) is a rare entity characterized by epilepsy and aphasia. It occurs in previously normal children, usually between three and seven years of age. The long-term outcome of LKS is not completely clear. The aim of this study is to verify the long-term follow-up of a group of patients with LKS, focusing on clinical and electroencephalographic (EEG) aspects, and quality of life. METHODS: This was a transversal study. Between November 2006 and April 2007 seven patients with previous diagnosis of LKS were interviewed. They had had a follow-up of three to 16 years after their disease onset. They were all males between the ages of eight and 27 years old. All patients had normal MRI. Parents and/or patients were interviewed by one of the authors using a structured questionnaire. The Vineland Adaptive Behavior Scales, the Conner's Rating Scales-Revised, and Short-Form Health Survey (SF 36) were used. Each patient had a prolonged interictal EEG recording. All patients had normal MRI. RESULTS: The present investigation revealed that two patients still have seizures several years after epilepsy onset. One patient had total and three others had partial remission of language disturbance, while three patients still have aphasia and verbal auditory agnosia. With respect to quality of life, only one of our patients has a normal life at present. The remaining six patients with some sort of limitation consider the aphasia/agnosia to be the main difficulty in their lives. Five patients have normal EEGs. CONCLUSIONS: The long-term follow-up of patients with LKS shows that epilepsy and EEG abnormalities do not always disappear. Language disturbances tend to persist in most patients. The age of onset of language dysfunction does not seem to correlate with the prognosis for recovery of language function. Patients with LKS have an overall poor quality of life, mostly due to language difficulties.
Assuntos
Epilepsia/fisiopatologia , Síndrome de Landau-Kleffner/fisiopatologia , Transtornos da Linguagem/fisiopatologia , Adolescente , Adulto , Fatores Etários , Agnosia/etiologia , Agnosia/fisiopatologia , Afasia/etiologia , Afasia/fisiopatologia , Criança , Eletroencefalografia/métodos , Epilepsia/etiologia , Seguimentos , Humanos , Síndrome de Landau-Kleffner/complicações , Síndrome de Landau-Kleffner/diagnóstico , Transtornos da Linguagem/etiologia , Imageamento por Ressonância Magnética , Masculino , Prognóstico , Qualidade de Vida , Inquéritos e Questionários , Fatores de Tempo , Adulto JovemRESUMO
Foram selecionadas 20 crianças com diagnóstico de epilepsia benigna da infância com pontas centrotemporais. Realizou-se anamnese, exame neurológico, aplicação da Escala de Maturidade Mental'' Columbia'' (1993) e eletrencefalograma digital. (EEG) O EEG digital foi gravado com eletrodos de acordo com o sistema internacional 10-20, acrescido de um eletrodo suplementar entre o eletrodos C3 eT3 ou C4 e T4 no lado onde ocorreu o maior número de pontas. Foi realizada a promediação dessas descargas para análise do local de máxima negatividade. A ocorrência de crises envolvendo um membro superior foi proporcionalmente maior nos sujeitos com pontas de máxima negatividade em C3, C4 do que em C5, C6, T3 ou T4. A atividade epileptiforme não centrotemporal associada foi mais frequente nos sujeitos com descargas centrotemporais de máxima negatividade em C3 e C4. Esse estudo demonstra a existência de diferenças clínicas e eletrencefalográficas de acordo com a localização das descargas centrotemporais
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Córtex Cerebral/fisiopatologia , Eletroencefalografia , Epilepsia Rolândica/fisiopatologia , Mapeamento Encefálico , Potenciais Evocados/fisiologia , Processamento de Imagem Assistida por Computador , Lobo Occipital/fisiopatologia , Lobo Parietal/fisiopatologia , ConvulsõesRESUMO
Twenty children with benign childhood epilepsy with centrotemporal spikes were studied. Anamnesis, neurological exam, "Columbia" Scale (1993) application and digital electroencephalogram were carried out. The digital electroencephalogram was recorded with electrodes according to 10-20 international system, and a supplementary electrode, between C3 and T3 or C4 and T4-C5 or C6, respectively, at the side with a higher number of spikes. The averaging of the spikes was carried. Localization and the laterality of the spikes were analyzed. Seizures involving a superior limb occurred in a higher proportion of cases with spikes of maximum negativity in C3, C4. Independent epileptiform activity, different from centrotemporal, was more frequent in the cases were the maximum negativity of the spikes occurred in C3 or C4 regions. There are clinical and electroencephalographic differences according to the localization of the discharges