title: Multifactorial etiology of interictal behavior in frontal and temporal lobe epilepsy.
abstract: OBJECTIVE
  Based on discussions on the so called "epileptic personality" in patients with epilepsy, interictal behavioral impairments in frontal and temporal lobe epilepsies were examined in a multivariate approach that took demographic, clinical, and neuropsychological determinants into consideration.
  
  
  METHODS
  A total of 428 patients with epilepsies originating from the temporal (TLE; 84%) or frontal (FLE; 16%) lobes were examined in regard to personality (Fragebogen zur Persönlichkeit bei zerebralen Erkrankungen [FPZ], a clinical personality questionnaire) and mood (Beck Depression Inventory [BDI I]). Prevalence of impaired behavioral domains was determined. Etiologically relevant determinants of behavioral problems were identified via multiple regression analyses.
  
  
  RESULTS
  Elevated depression scores (BDI) were evident in 42% of the patients, and not different in TLE and FLE. In regard to personality, introversion together with low mood, sociability, and self-determination, as well as problems with interpersonal communication were frequent. The TLE group tended to show greater neuroticism and introversion, while FLE appeared more associated with behavioral aspects of an organic psychosyndrome. Multivariate analyses revealed demographic characteristics (age, gender, education), clinical aspects (psychiatric history, affected hemisphere, mesial pathology, seizure frequency, cognitive functions), and treatment (antiepileptic drug treatment) as relevant determinants, explaining up to 30% of the behavior.
  
  
  CONCLUSIONS
  Behavioral abnormalities in patients with frontal or temporal lobe epilepsy are common but on the average mostly mild. Within a multivariate etiological model, localization (mesial yes/no) and lateralization (left > right) dependent behavioral problems in TLE and FLE seem to be overshadowed by other variables, of which patients' and their families' psychiatric history, patient characteristics and pharmacological treatment appear of major importance. Better education and cognitive capabilities may be discussed as protective features.
authors.affiliation: Department of Epileptology, University of Bonn, Bonn, Germany. c.helmstaedter@uni-bonn.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Helmstaedter
authors.forename: Juri-Alexander
authors.initials: JA
authors.lastname: Witt
mesh_terms: D000328:Adult; D001526:Behavioral Symptoms / Q000209:etiology; D004569:Electroencephalography; D017034:Epilepsy, Frontal Lobe / Q000150:complications / Q000209:etiology* / Q000523:psychology; D004833:Epilepsy, Temporal Lobe / Q000150:complications / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010554:Personality Disorders / Q000209:etiology; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D055815:Young Adult