O temperamento em pacientes com epilepsia temporal mesial refratária : análise qualitativa e impacto de variáveis epileptiformes

Abstract

Introduction: Although temporal lobe epilepsy is associated with high rates of psychiatric comorbidities, investigations about the temperament of these patients have been neglected. Previous studies have suggested that epileptiform and clinical variables may have a role in this context. Objectives: The present study characterized, through a reliable instrument, the temperament of patients with mesial temporal lobe epilepsy, compared them to controls and established relationships with disease-related variables. Methods: Temperament was assessed in 42 (forty-two) adult patients with unilateral mesial temporal lobe epilepsy and 84 (eighty-four) control, through the questionnaire AFECTS (Affective and Emotional Composite Temperament Scale). Among patients, variables related to epilepsy were collected prospectively as well as the scales of the BDI and BAI. Results: Statistically significant correlations were observed between disease duration and higher BDI against temperaments "Depressive" and "Anxious" and the emotional dimension of temperament "Fear." The number of antiepileptic drugs correlated inversely with the temperament "Obsessive." Regarding laterality, patients with lesion in the left lobe had lower average in the emotional dimension "Sensitivity". Discussion: Even though some findings, such as higher BDI scores in patients with temperament "Depressive" and "Anxious" could be justified by the bigger prevalence of psychiatric disorders in patients with mesial temporal lobe epilepsy, statistically significant correlations were found between affective dimensions and variables, independently. Lower means of "Sensitivity" in patients with left itcal focus were consistent with recent data about neurobiological basis of temperament. Conclusion: While they should be interpreted with caution, the results suggest a possible role of mesial temporal lobe epilepsy, directly and through lesion, as one of the determinants of temperament in these patients.