ABSTRACT
INTRODUCTION AND OBJECTIVES: Epilepsy is a chronic illness which causes psychosocial problems in the patients affected. These disorders may be investigated by using the Washington Psychosocial Inventory (WPSI). We wish to show the variables which affect the WPSI most and also the changes seen in the results of this test and the control of seizures after treatment with lamotrigine for a year. PATIENTS AND METHODS: Using the WPSI, we studied 70 patients in the epilepsy outpatient clinic of the Psychiatric Hospital in La Habana during the period February-March 1998. The results of the WPSI were analysed according to the following variables: cerebral lesion, age of onset of epilepsy, frequency of seizures, more than one seizure per patient, and the antiepileptic drug used. The patients were followed-up during one year of treatment with lamotrigine, and the WPSI was repeated after one year (in March 1999). The following statistical tests were used to find the level of significance: variance analysis, standard deviation, chi deviation and difference between means. RESULTS: The WPSI showed initially, at almost all levels, poor scoring; 48.86% had generally poor psychosocial function (FPG). Only the greater frequency of seizures significantly altered the WPSI. After treatment with lamotrigine for one year there was better seizure control, a better WPSI result and only 11.43% had poor FPG. CONCLUSIONS: We consider that the high frequency of seizures is the variable which most affects the WPSI and that lamotrigine is useful both for control of epileptic seizures and to obtain psychosocial rehabilitation.
Subject(s)
Adaptation, Psychological , Anticonvulsants/therapeutic use , Epilepsy/drug therapy , Triazines/therapeutic use , Adult , Chronic Disease , Epilepsy/psychology , Female , Follow-Up Studies , Humans , Interpersonal Relations , Lamotrigine , Male , Severity of Illness Index , Treatment OutcomeABSTRACT
Introducción y objetivos. La epilepsia como enfermedad crónica ocasiona problemas psicosociales en los pacientes que la padecen. Dichos trastornos se pueden conocer mediante el Inventario Psicosocial de Washington (WPSI). Queremos mostrar las variables que más afectan al WPSI así como el cambio en los resultados de esta prueba y el control de las crisis tras un año de tratamiento con lamotrigina. Pacientes y métodos. Se estudian, mediante el WPSI, 70 pacientes en la consulta externa de epilepsia del Hospital Psiquiátrico de La Habana, durante el período febrero-marzo de 1998.Los resultados del WPSI se analizaron según las siguientes variables: lesión cerebral, edad de inicio de la epilepsia, frecuencia de crisis, más de una crisis por enfermo y antiepiléptico utilizado. Se siguió a los pacientes durante un año con tratamiento con lamotrigina y se repitió el WPSI al año (marzo de 1999). Se realizaron las siguientes pruebas estadísticas en busca del nivel de significación: análisis de varianza, desviación estándar, desviación ji y diferencia entre medias. Resultados. El WPSI mostró al inicio, en casi todas sus escalas, mala calificación; el 48,86 por ciento tenían mal funcionamiento psicosocial general (FPG). Sólo una mayor frecuencia de las crisis variaba significativamente el WPSI. Después del año con lamotrigina existía mayor control de las crisis, mejor resultado del WPSI y sólo el 11,43 por ciento tenían mal FPG. Conclusiones. Se considera que la elevada frecuencia de crisis es la variable que más afecta al WPSI y que la lamotrigina es útil tanto en el control de las crisis de epilepsia como en lograr una reincorporación psicosocial (AU)
Subject(s)
Child , Child, Preschool , Adult , Adolescent , Male , Infant , Female , Humans , Adaptation, Psychological , Spain , Risk Factors , Triazines , Tomography, X-Ray Computed , Treatment Outcome , Retrospective Studies , Recurrence , Anticonvulsants , Cerebral Infarction , Chronic Disease , Cytomegalovirus Infections , Acute Disease , Anemia , Magnetic Resonance Imaging , Interpersonal Relations , Epilepsy , Follow-Up Studies , Severity of Illness Index , Telencephalon , Catchment Area, HealthABSTRACT
PATIENTS AND METHODS: Fifty patients diagnosed as having epileptic crises were given neuropsychological tests including the Wechsler Adult Intelligence Scale or WAIS, Luria's neuropsychological test and a quantitative EEG examination. Multivariate analysis was done of the following variables: presence or absence of inter-octal psychosis, onset of crises before the age of 10 years, frequency of crises or status epilepticus greater than 100, known cause or otherwise of epilepsy, and the presence of more than one type of crisis in a particular patient. The working hypothesis was to show that the association of epilepsy and psychosis causes alterations in superior psychic functions (SPF) particularly of the frontal lobes. The WAIS test, intelligence, verbal and executive quotients and the 11 subtests were evaluated using multivariate analysis (ANOVA) conditioned by the different variables studied. The broad band spectral measurements of the quantitative EEG (BBSM) were studied using a statistical programme (COMPARA) by which the groups of individuals were compared with a standard group, using the Student t and Fisher tests. The different BBSM variables studied were: absolute power, relative power and total dominant frequency. RESULTS: Amongst the most important results were: reduction in the performance scale of epileptics with chronic psychosis, alterations on the verbal scale in epileptics with more than one type of crisis, presence of frontal and fronto-temporal dysfunction in epileptics with chronic psychosis and negative signs of schizophrenia. On the quantitative EEG in epileptics with psychosis there was abnormally slow activity predominantly in the frontal lobes. CONCLUSIONS: From the overall results we may conclude that in patients with epilepsy and chronic psychosis there is cortical dysfunction of the frontal lobe.
