Epilepsia do lobo temporal: Relato de um paciente intacto após 26 anos de evolução sem tratamento

Hernández-Fustes, Otto J.; Bittencourt, Paulo Rogério M. de

doi:10.1590/S0004-282X1995000300025

Resumos

Apresentamos o caso de um paciente de 36 anos de idade com quadro clínico de epilepsia do lobo temporal, com crises tônico-clônicas desde os 10 anos de idade e parciais complexas desde os 30 anos, que nunca havia recebido tratamento. O diagnóstico foi feito clinicamente e com apoio do eletrencefalograma. A tomografia computadorizada de crânio foi normal. Foi realizado estudo das funções cognitivas com métodos validados em população de pacientes com epilepsia, da mesma origem social e geográfica que o paciente; os resultados foram semelhantes aos obtidos para a população de controle. O paciente também não mostrava alterações aos exames clínico geral, neurológico e das funções mentais. Ele tinha desempenho normal na sociedade, com estrutura familiar estável composta de esposa e filhos, e com emprego estável.

epilepsia do lobo temporal; funções cognitivas; drogas antiepilépticas

We present the case of a 36 years old man with temporal lobe epilepsy since 10 years old without treatment, and daily complex partial seizures and weekly tonic-clonic seizures. The diagnosis was made by clinical aspects and electroencephalographic findings. CT scan was normal. Cognitive functions were tested and showed no alterations. The patient had normal clinic, neurologic and mental exam.

temporal lobe epilepsy; cognitive functions; antiepileptic drugs

Otto J. Hernández-Fustes^I; Paulo Rogério M. de Bittencourt^II

^INeurologista. Serviços de Neurologia e Eletroencefalografia, Programa de Cirurgia de Epilepsia do Hospital Nossa Senhora das Graças, Unidade de Neurologia Clínica S/C Ltda, Curitiba

^IIChefe dos Serviços de Neurologia e Eletroencefalografia, Coordenador do Programa de Cirurgia de Epilepsia. Serviços de Neurologia e Eletroencefalografia, Programa de Cirurgia de Epilepsia do Hospital Nossa Senhora das Graças, Unidade de Neurologia Clínica S/C Ltda, Curitiba

RESUMO

Apresentamos o caso de um paciente de 36 anos de idade com quadro clínico de epilepsia do lobo temporal, com crises tônico-clônicas desde os 10 anos de idade e parciais complexas desde os 30 anos, que nunca havia recebido tratamento. O diagnóstico foi feito clinicamente e com apoio do eletrencefalograma. A tomografia computadorizada de crânio foi normal. Foi realizado estudo das funções cognitivas com métodos validados em população de pacientes com epilepsia, da mesma origem social e geográfica que o paciente; os resultados foram semelhantes aos obtidos para a população de controle. O paciente também não mostrava alterações aos exames clínico geral, neurológico e das funções mentais. Ele tinha desempenho normal na sociedade, com estrutura familiar estável composta de esposa e filhos, e com emprego estável.

Palavras-chave:epilepsia do lobo temporal, funções cognitivas, drogas antiepilépticas.

SUMMARY

We present the case of a 36 years old man with temporal lobe epilepsy since 10 years old without treatment, and daily complex partial seizures and weekly tonic-clonic seizures. The diagnosis was made by clinical aspects and electroencephalographic findings. CT scan was normal. Cognitive functions were tested and showed no alterations. The patient had normal clinic, neurologic and mental exam.

Key words:temporal lobe epilepsy, cognitive functions, antiepileptic drugs.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Agradecimento - Reconhecemos o exame inicial de função cognitiva realizado no paciente por M.J. Mader, M.M. Bigarella e M.P. Dóro.

Aceite: 16-fevereiro-1995.

Dr. Otto J. Hernández-Fustes - Rua Raquel Prado 203 - 80510-360 Curitiba PR - Brasil.

1. Adams RD. Hipocrates: the genuine Works of Hipocrates. Baltimore: Williams and Wilkins, 1939.
2. Arteaga RC, Caro RA, Rodriguez RL, Hernández-Fustes OJ, Goizueta SM, Garcia GA. Rendimieto intelectualy y crisis epilépticas. JLBE 1993, 6:61-63.
3. Bigarella MM, Mader MJ, Doro MP, Gorz AM, Marcourakis T, Tsanaclis L, Bittencourt PRM. Cognitive functions of epileptic patients on monotherapy with phenobarbitone and healthy controls. Arq Neuropsiquiatr 1991, 49:136-141.
4. Bittencourt PRM. Cerebral and cerebellar atrophy in patients with severe epilepsy: a preliminary report. In Oxley J, Janz D, Meinardi H (eds). Chronic toxicity of antiepileptic drugs. New York: Raven Press, 1983, p 237-246.
5. Bittencourt PRM. Epilepsy in developing countries: Latin American aspects. In Laidlaw J, Richens A, Oxley J (eds). Textbook of epilepsy. Ed 3. Edinburgh: Churchill-Livingstone 1988, p 518-527.
6. Bittencourt PRM, Kowacs PA, Mader MJ, Bigarella MM. Antiepileptic drugs and cognitive functions (Abstr). Epilepsia 1990, 31:654.
7. Bittencourt PRM, Mader MJ, Bigarella MM, Doro MP, Gorz AM, Marcourakis TM, Ferreira ZS. Cognitive functions, epileptic syndromes and antiepileptic drugs. Arq Neuropsiquiatr 1992, 50:24-30.
8. Bittencourt PRM, Antoniuk SA, Bigarella MM, Costa JC, Doro MP, Ferreira AS, Fonseca LC, Gorz A, Silva GEG, Marcourakis TM, Tedros GMAS. Carbamazepine and phenytoin in epilepsies refractory to barbiturates: efficacy, toxicity and metal function. Epilep Res 1993, 16:147-155.
9. Bittencourt PRM, Mazer S, Marcourakis T, Bigarella MM, Ferreira ZS, Mumford JP. Vigabatrin: clinical evidence supporting rational polytherapy in management of uncontrolled seizures. Epilepsia 1994, 35:373-380.
10. Conlon P, Trimble MR, Rogers D. A study of epileptic psychosis using magnetic resonance imaging. Br J Psychiatry 1990, 156:231-235.
11. Dodrill CB. Cognitive effects of anti-epileptic drugs. J Clin Psychiatry 1988, 49:31-34.
12. Dodrill CB, Troupin AS. Neuropsychological effects of carbamazepine and phenytoin: a reanalysis. Neurology 1991, 41:141-143.
13. Dreifuss FE. The patient with refractory seizures. In Resor SR, Kutt H (eds). The medical treatment of epilepsy. New York: Marcel Dekker 1992, p 175-181.
14. Farwell JR, Dodrill CB, Batzel LW. Neuropsychological abilities of children with epilepsy. Epilepsia 1985, 26:395-400.
15. Girvin LP. Is epilepsy a progressive disorder? J Epilep 1992, 20:94-104.
16. Gower WR. Epilepsy and other chronic convulsive diseases. London: Churchill, 1881.
17. Hernández-Fustes OJ II, Hernández-Fustes OJ I, Hernández-Cossio O. Trastornos psiquiátricos y/o epilepsia. Arch Hosp Santo Tomas (Panamá) 1993 1:39-45.
18. Lennox WG, Lennox MA. Epilepsy and related disorders. London: JA Churchill, 1960.
19. Meador KJ, Loring DW, Allen ME, Zamrini EY, Moore EE, Abney OL, King DW. Comparative cognitive effects of carbamazepine and phenytoin in healthy adults. Neurology 1991, 41:1537-1540.
20. Ossetin J. Methods and problems in the assessment of cognitive function in epileptic patients. In Trimble MR, Reynold H (eds). Epilepsy, behavior and cognitive function. Cichester: John Wiley, 1988, pl2-26.
21. Parada R. Aspectos psicopatológicos en los pacientes con epilepsia: contribution al campo de la epileptología. In Devilat M (ed). Las epilepsias: investigaciones clínicas. Santiago: Ciba-Geigy, 1991, pl2S-137.
22. Penry JF (ed). Epilepsy bibliography 1950-1975. Bethesda: Department of Health, Education and Welfare, 1976.
23. Pond DA. Psychiatric aspects of epilepsy. J Ind Med Prof 1957, 3:1441-1451.
24. Ramani V, Gummit RJ. Intensive monitoring of interictal psychosis in epilepsy. Ann Neurol 1982, 11:613-622.
25. Rutter M, Graham P, Yule W. Neuropsychiatry study in childhood. In Clinics in developmental medicine. London: Heinemann, 1970.
26. Trimble MR. The psycopathology of epilepsy. Horsham: Geigy, 1981.
27. Trimble MR. Psychiatric aspects of epilepsy. Psychiatr Dev 1987, 5:285-300.

Epilepsia do lobo temporal. Relato de um paciente intacto após 26 anos de evolução sem tratamento

Temporal lobe epilepsy: report of an intact patient 26 years after onset, without treatment

Datas de Publicação

Publicação nesta coleção
09 Dez 2010
Data do Fascículo
Set 1995

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Adams RD. Hipocrates: the genuine Works of Hipocrates. Baltimore: Williams and Wilkins, 1939.

[2] 2. Arteaga RC, Caro RA, Rodriguez RL, Hernández-Fustes OJ, Goizueta SM, Garcia GA. Rendimieto intelectualy y crisis epilépticas. JLBE 1993, 6:61-63.

[3] 3. Bigarella MM, Mader MJ, Doro MP, Gorz AM, Marcourakis T, Tsanaclis L, Bittencourt PRM. Cognitive functions of epileptic patients on monotherapy with phenobarbitone and healthy controls. Arq Neuropsiquiatr 1991, 49:136-141.

[4] 4. Bittencourt PRM. Cerebral and cerebellar atrophy in patients with severe epilepsy: a preliminary report. In Oxley J, Janz D, Meinardi H (eds). Chronic toxicity of antiepileptic drugs. New York: Raven Press, 1983, p 237-246.

[5] 5. Bittencourt PRM. Epilepsy in developing countries: Latin American aspects. In Laidlaw J, Richens A, Oxley J (eds). Textbook of epilepsy. Ed 3. Edinburgh: Churchill-Livingstone 1988, p 518-527.

[6] 6. Bittencourt PRM, Kowacs PA, Mader MJ, Bigarella MM. Antiepileptic drugs and cognitive functions (Abstr). Epilepsia 1990, 31:654.

[7] 7. Bittencourt PRM, Mader MJ, Bigarella MM, Doro MP, Gorz AM, Marcourakis TM, Ferreira ZS. Cognitive functions, epileptic syndromes and antiepileptic drugs. Arq Neuropsiquiatr 1992, 50:24-30.

[8] 8. Bittencourt PRM, Antoniuk SA, Bigarella MM, Costa JC, Doro MP, Ferreira AS, Fonseca LC, Gorz A, Silva GEG, Marcourakis TM, Tedros GMAS. Carbamazepine and phenytoin in epilepsies refractory to barbiturates: efficacy, toxicity and metal function. Epilep Res 1993, 16:147-155.

[9] 9. Bittencourt PRM, Mazer S, Marcourakis T, Bigarella MM, Ferreira ZS, Mumford JP. Vigabatrin: clinical evidence supporting rational polytherapy in management of uncontrolled seizures. Epilepsia 1994, 35:373-380.

[10] 10. Conlon P, Trimble MR, Rogers D. A study of epileptic psychosis using magnetic resonance imaging. Br J Psychiatry 1990, 156:231-235.

[11] 11. Dodrill CB. Cognitive effects of anti-epileptic drugs. J Clin Psychiatry 1988, 49:31-34.

[12] 12. Dodrill CB, Troupin AS. Neuropsychological effects of carbamazepine and phenytoin: a reanalysis. Neurology 1991, 41:141-143.

[13] 13. Dreifuss FE. The patient with refractory seizures. In Resor SR, Kutt H (eds). The medical treatment of epilepsy. New York: Marcel Dekker 1992, p 175-181.

[14] 14. Farwell JR, Dodrill CB, Batzel LW. Neuropsychological abilities of children with epilepsy. Epilepsia 1985, 26:395-400.

[15] 15. Girvin LP. Is epilepsy a progressive disorder? J Epilep 1992, 20:94-104.

[16] 16. Gower WR. Epilepsy and other chronic convulsive diseases. London: Churchill, 1881.

[17] 17. Hernández-Fustes OJ II, Hernández-Fustes OJ I, Hernández-Cossio O. Trastornos psiquiátricos y/o epilepsia. Arch Hosp Santo Tomas (Panamá) 1993 1:39-45.

[18] 18. Lennox WG, Lennox MA. Epilepsy and related disorders. London: JA Churchill, 1960.

[19] 19. Meador KJ, Loring DW, Allen ME, Zamrini EY, Moore EE, Abney OL, King DW. Comparative cognitive effects of carbamazepine and phenytoin in healthy adults. Neurology 1991, 41:1537-1540.

[20] 20. Ossetin J. Methods and problems in the assessment of cognitive function in epileptic patients. In Trimble MR, Reynold H (eds). Epilepsy, behavior and cognitive function. Cichester: John Wiley, 1988, pl2-26.

[21] 21. Parada R. Aspectos psicopatológicos en los pacientes con epilepsia: contribution al campo de la epileptología. In Devilat M (ed). Las epilepsias: investigaciones clínicas. Santiago: Ciba-Geigy, 1991, pl2S-137.

[22] 22. Penry JF (ed). Epilepsy bibliography 1950-1975. Bethesda: Department of Health, Education and Welfare, 1976.

[23] 23. Pond DA. Psychiatric aspects of epilepsy. J Ind Med Prof 1957, 3:1441-1451.

[24] 24. Ramani V, Gummit RJ. Intensive monitoring of interictal psychosis in epilepsy. Ann Neurol 1982, 11:613-622.

[25] 25. Rutter M, Graham P, Yule W. Neuropsychiatry study in childhood. In Clinics in developmental medicine. London: Heinemann, 1970.

[26] 26. Trimble MR. The psycopathology of epilepsy. Horsham: Geigy, 1981.

[27] 27. Trimble MR. Psychiatric aspects of epilepsy. Psychiatr Dev 1987, 5:285-300.