NEUROPSYCHOLOGICAL STUDY DURING VIDEO-EEG RECORDING OF SUCCESSIVE PARTIAL SEIZURES OF RIGHT TEMPORO-CENTRAL ORIGIN

A 15-year-old, right-handed boy underwent video-EEG study as a first s tep in presurgical evaluation for a severe drug-resistant right tempor o-central epilepsy. He was monitored while performing neuropsychologic al tests over a 67-minute period during which 23 brief seizures were r ecorded. Despite his right-handedness, both inter-ictal and ictal verb al performances were impaired. Analysis of the relationships between t he characteristics of the EEG and the neuropsychological results revea led that a worsening in cognitive performances correlated with an incr ease in inter-ictal abnormalities, particularly when subclinical parox ysms were present; that the cognitive tasks executed peri-ictally were correctly performed in almost 50% of the cases; and that the error ra te was higher when a task wa presented during or immediately after a s eizure rather than before its onset. A Wada test, performed on the bas is of the cognitive results, demonstrated right hemisphere dominance f or language. Our observations underline the importance of neuropsychol ogical testing in presurgical procedures, and suggest that it should b e performed peri-ictally whenever possible.