ATTENTION CHARACTERIZATION IN PATIENTS WITH FRONTAL AND TEMPORAL LOBE EPILEPSY

Objectives. Patients with epilepsy exhibit various neuropsychological disorders (Loring et al., 2010; Braakman et al., 2011). The objective of the present study is to investigate some peculiar functions of attention in a population of patients with frontal lobe (FLE) or temporal lobe epilepsy (TLE). Patients. 18 patients of 20-65 years of age and suffering from FLE (8 patients) or TLE (10 patients) were examined. All patients have been defined through periodic EEG records, and neuro-imaging techniques (TC/RMI). Eight pts were stabilized on mono-therapy and ten were taking two or three antiepileptic drugs. Seizure frequency in the last month ranged from 1 to 3 focal fits per month. Patients with a diagnosis of epilepsy of more than 5 years were excluded. Patients with mental retardation, psychiatric disorders or previous cranial traumas were also excluded. Methods. Alertness, selective attention, divided attention, and sustained attention were selectively examined through a specific set of tests for the Examination of the Attention (TEA) (Zimmermann and Fimm 1992 and 1994). Statistical analysis were carried out through a student t test for paired data. Results. Alertness test: 11/18 of the patients (61%) exhibited an insufficient performance (under the 5th percentile), both in the task with warning signal and without it. Selective attention: 12/18 of the patients (66%) exhibited a performance under the standard with a score below the 5th percentile in the reaction times. Divided attention:10/18 of the patients (55%) had a seriously insufficient performance, particularly evident in ten patients (< 5th percentile). Sustained attention: 18/18 patients (100%) showed normal values. No statistically significant differences were detected between FLE and TLE patients in relation to mono- vs poly-therapy and to the various functions tested. Discussion. Reduced reaction times, during both simple and organized visual situations, were observed in all patients. All were unable to use effectively the warning stimulus. This is a sign of a low arousal level of the selective and divided attention with a gap in the management of multiple stimulus. Thus, a double impairment, concerning both the intensive component and the selective one of the attention processes, occurs. The sustained attention was normal in all patients. It is noteworthy that the objective results did not show any correlation with the subjective disturbances reported by the patients. Conclusions. Attention disorders need to be taken into a due consideration because they may significantly affect various aspects of the quality of life of patients with epilepsy.