Abstract
Disorders of executive functioning have recently been reported in patients with juvenile myoclonic epilepsy (JME); however, data on other syndromes of generalized idiopathic epilepsy (IGE) other than JME, especially in adolescence, are scarce. The aim of this study was to explore specific executive functions in a group of adolescents with IGE of short duration and to evaluate the possible factors that might influence these functions. Neuropsychological investigation of executive functions (the Verbal Fluency Test, the Five-Point Test, the Trail-Making Test, and the Stroop test) was performed in 59 patients aged 14-17 years and meeting the diagnostic criteria for IGE, and in the group of 59 age-matched controls without any history of epilepsy. The IGE group subjects scored worse than the controls in most of the executive function tests: phonemic (P=0.008) and semantic (P=0.001) word fluency, figural fluency (P=0.008), visual search and sequencing of numbers (P=0.001), and alternate number-letter sequencing (P=0.018). None of the test scores differed between the new-onset and the established IGE groups, or between the groups of cases with and without myoclonias. No relationship between executive functioning and gender, age, duration or activity of epilepsy, chronic use of treatment, or epileptiform discharges on electroencephalography was found. Executive dysfunction was present in adolescents with JME and other syndromes of IGE, manifesting with generalized tonic-clonic seizures without myoclonias, despite short duration and benign course of epilepsy.
Highlights
Idiopathic generalized epilepsies (IGEs) of adolescence comprise a group of age-related epilepsy syndromes characterized by generalized seizures that have a genetic origin and no detectable brain lesion [1, 2]
Executive dysfunction was present in adolescents with juvenile myoclonic epilepsy (JME) and other syndromes of IGE, manifesting with generalized tonic-clonic seizures without myoclonias, despite short duration and benign course of epilepsy
Since myoclonic jerks are considered to be obligatory for the diagnosis of JME [2], the patients were divided into two groups according to the presence (M+) or absence (M–) of myoclonic jerks: those with myoclonic jerks were defined as having JME, and patients without myoclonias and with generalized tonic clonic seizures (GTCSs) as the only seizure type were defined as having IGE with “GTCSs only.”
Summary
Idiopathic generalized epilepsies (IGEs) of adolescence comprise a group of age-related epilepsy syndromes characterized by generalized seizures that have a genetic origin and no detectable brain lesion [1, 2]. The impairment of various cognitive functions such as attention, memory, and executive functions in patients with IGE has been reported [4, 6,7,8]. The impairment of certain cognitive functions is very important in school-aged patients since it may influence their learning process and lead to psychosocial and professional impact even for children with normal intelligence and well-controlled seizures [4, 9]. Data from studies involving patients with JME show a range of deficits in various executive functions [6, 11,12,13] suggesting the impairment of frontal and prefrontal regions. Results of the studies are inconsistent, and there is some evidence that slight abnormalities of frontal
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