González-Pal S, Faure A, Quintana J, Fabelo R, Domínguez M E, Gómez-Plasencia R, Sánchez M J
Servicio de Epilepsia y Neurología, Hospital Psiquiátrico de La Habana, Cuba.
Rev Neurol. 1999;28(3):219-23.
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.
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.
From the overall results we may conclude that in patients with epilepsy and chronic psychosis there is cortical dysfunction of the frontal lobe.
五十名被诊断为癫痫发作的患者接受了神经心理学测试，包括韦氏成人智力量表（WAIS）、鲁利亚神经心理学测试以及定量脑电图检查。对以下变量进行了多变量分析：是否存在间发性精神病、10岁前发作、癫痫发作或癫痫持续状态频率大于100、癫痫已知病因与否以及特定患者中是否存在不止一种发作类型。工作假设是表明癫痫与精神病的关联会导致高级心理功能（SPF）尤其是额叶的改变。使用由所研究的不同变量作为条件的多变量分析（方差分析）对WAIS测试、智力、言语和执行商数以及11个分测试进行评估。使用统计程序（COMPARA）研究定量脑电图的宽带频谱测量（BBSM），通过该程序将个体组与标准组进行比较，采用学生t检验和费舍尔检验。所研究的不同BBSM变量包括：绝对功率、相对功率和总主导频率。
最重要的结果包括：患有慢性精神病的癫痫患者操作量表得分降低、患有不止一种发作类型的癫痫患者言语量表出现改变、患有慢性精神病的癫痫患者存在额叶和额颞叶功能障碍以及精神分裂症的阴性症状。患有精神病的癫痫患者的定量脑电图显示额叶主要存在异常缓慢的活动。
从总体结果我们可以得出结论，癫痫和慢性精神病患者存在额叶皮质功能障碍。
