Introduction.The current knowledge of significance of some neurobiological and clinical variables in the prediction of remission length and seizures reduction in partial epilepsies remains sparse and even controversial. Aim. The current study has been carried out in order to evaluate the possible relationship between epilepsy forms, gender, focus lateralization and handedness with therapeutic remission and seizures reduction during antiepileptic treatment in persons with partial forms of epilepsy. Material and methods. One hundred and eight patients were studied. Handedness was evaluated using the Annett's scale. Focus lateralization was detected by use of the EEG. Of the patients studied temporal lobe epilepsy (TLE) was diagnosed in 61 cases and frontal lobe epilepsy (FLE) in 47 cases. There were 44 men and 64 women, of which 83 were right-handed and 25 were left-handed. A left-sided focus was detected in 59 persons whilst a right-sided focus was noted in 49 persons. MANOVA was used for the analysis of interrelationship between four nominal fixed factors (epilepsy forms, gender, handedness, and focus laterality) and dependent variables of therapeutic remission and percentage seizures reduction. Results. A favorable prognostic significance of FLE vs TLE was observed. In contrast gender, handedness, and focus laterality had no influence on the dependent variables when analyzed separately. However, when two, three and four independent variables were combined an influence on the dependent variables was observed; and some combinations may be used for prediction purposes of therapeutic remission and percentage in seizure reduction. The FLE in the men with the right-handedness and the left focus (FLE • M • Rh • LF) resulted in the maximal length of therapeutic remission and maximal seizures reduction, while the other combinations have resulted in less favorable treatment results. The TLE • M • Rh • RF and TLE • M • Lh • LF were the worst combinations for the remission length and TLE • Fe • Lh • LF for the seizures reduction. Conclusions. The current study revealed the significance of combinations of some neurobiological and clinical variables in prediction of therapeutic remission and percent of seizures reduction irrespective of used antiepileptic drugs. These results may be used so as to aid patient selection before drug treatment in order to form the homogenous groups of persons.
Introduction. The current knowledge of significance of some neurobiological and clinical variables for the development of cognitive deterioration in patients with epilepsy remains sparse and controversial. Aim. The current study has been carried out in order to elucidate the role of handedness in terms of influence on cognitive processing and intelligence in patients with epilepsy. Material and methods. One hundred and thirty two patients (62 males, 70 females, aged 27.8 ± 8.9 years) with epilepsy participated in the study. Patients were divided into two groups. The first group included 112 patients that were characterized by intelligence and cognitive impairment while the second group (20 patients) had no mental deterioration and was regarded as controls. The two diagnostic categories accorded with ICD-10 criteria. The diagnosis of Dementia (F-02.8) was confirmed in 54 patients, while the diagnosis of Mild Cognitive Impairment (F-06.7) was confirmed in 58 patients. Results. Our results show that the level of left-handers among patients with cognitive Impairment achieved 14.2%, whilst in the group without cognitive deterioration there were no left-handers, and this difference was statistically significant (p = 0.051). An analysis of possible influence of motor lateralization on degree of cognitive deterioration, revealed that left-handedness determines the higher degrees of intelligence deterioration compared with right-handedness (χ2 = 6.64; p < 0,05). These data were confirmed by use of Wechsler Adult Intelligence Scale (WAIS) and the Mini Mental State Examination (MMSE) tests, and all left-handed epilepsy patients achieved lower scores on MMSE, total WAIS, as well as verbal and nonverbal WAIS scores. Conclusion. Our data confirm a role of some neurobiological variables, with emphasis on cerebral motor lateralization, in their influence upon intelligence level and cognitive deterioration in epilepsy. These data may be used for predictive purposes of intelligence assessment in patients with epilepsy.
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