Neuropsychological aspects of frontal lobe epilepsy

While most neuropsychological studies in focal epilepsies are concerned with temporal lobe epilepsy (TLE), only few investigations aim cognitive functioning in unresected patients with frontal lobe epilepsy (FLE). Following functional models arising from lesional studies, we evaluated patients with TLE (21 left, 17 right) and FLE (6 left, 17 right) with respect to attention and speed, motor coordination, verbal/nonverbal fluency, concept formation, response inhibition, anticipatory behavior and memory span. The following results were obtained. When compared to TLE, FLE was associated with significantly poorer results in almost all tests, fluency tests being the exception. No group differences were found with respect to the lateralization of the epileptic focus or the presence or absence of cerebral lesions. Factor analysis of the tests indicated that different subfunctions (speed, STM, motor coordination, response maintenance and inhibition) were assessed. A particular cognitive pattern of impaired motor coordination or response inhibition appeared to be characteristic for patients with FLE.