313 Medicina (Kaunas) 2011;47(6) Medicina (Kaunas) 2011;47(6):313-9 Executive Functions in Adolescents With Idiopathic Generalized Epilepsy Giedrė Gelžinienė 1 , Giedrė Jurkevičienė 1 , Vitalija Marmienė 2 , Virginija Adomaitienė 2 , Milda Endzinienė 1 1 Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, 2 Department of Psychiatry, Medical Academy, Lithuanian University of Health Sciences, Lithuania Key words: idiopathic generalized epilepsy; executive functions; myoclonias; generalized tonic- clonic seizures. Summary. Disorders of executive functioning have recently been reported in patients with juve- nile myoclonic epilepsy (JME); however, data on other syndromes of generalized idiopathic epilepsy (IGE) other than JME, especially in adolescence, are scarce. The aim of this study was to explore specific executive functions in a group of adolescents with IGE of short duration and to evaluate the possible factors that might influence these functions. Material and Methods. Neuropsychological investigation of executive functions (the Verbal Flu- ency Test, the Five-Point Test, the Trail-Making Test, and the Stroop test) was performed in 59 patients aged 14–17 years and meeting the diagnostic criteria for IGE, and in the group of 59 age- matched controls without any history of epilepsy. Results. The IGE group subjects scored worse than the controls in most of the executive function tests: phonemic (P=0.008) and semantic (P=0.001) word fluency, figural fluency (P=0.008), visual search and sequencing of numbers (P=0.001), and alternate number-letter sequencing (P=0.018). None of the test scores differed between the new-onset and the established IGE groups, or between the groups of cases with and without myoclonias. No relationship between executive functioning and gender, age, duration or activity of epilepsy, treatment, or epileptiform discharges on electroencepha- lography was found. Conclusions. Executive dysfunction was present in adolescents with JME and other syndromes of IGE, manifesting with generalized tonic-clonic seizures without myoclonias, despite short dura- tion and benign course of epilepsy. Adresas susirašinėti: G. Gelžinienė, LSMU MA Neurologijos klinika, Eivenių 2, 50028 Kaunas El. paštas: giedregelziniene@hotmail.com Correspondence to G. Gelžinienė, Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, 50028 Kaunas, Lithuania E-mail: giedregelziniene@hotmail.com Introduction Idiopathic generalized epilepsies (IGEs) of ado- lescence comprise a group of age-related epilepsy syndromes characterized by generalized seizures that have a genetic origin and no detectable brain lesion (1, 2). IGE is considered a benign condition; patients usually have normal intellectual abilities, and their seizures are well controlled with antiepi- leptic drugs. Yet, the studies that evaluated intellec- tual abilities of patients with IGE have shown a ten- dency to lower IQ than in general population (3–5). The impairment of various cognitive functions such as attention, memory, and executive functions in patients with IGE has been reported (4, 6–8). The impairment of certain cognitive functions is very important in school-aged patients since it may in- fluence their learning process and lead to psychoso- cial and professional impact even for children with normal intelligence and well-controlled seizures (4, 9). Idiopathic epilepsies without structural brain changes constitute a better model for evaluating the impact of disease-related characteristics and parox- ysmal epileptic activity on cognitive functions than symptomatic epilepsies (10), and therefore investi- gations of various aspects of cognition in idiopathic epilepsies are in process. Recently, executive func- tions, mainly associated with the function of the frontal cortex, have gained much attention and have been studied in patients with epilepsy, particularly in case of juvenile myoclonic epilepsy (JME) (11– 14). Executive functions are a complex set of pro- cesses, thought to be responsible for the ability to plan and form abstract concepts and goals, adjust to changing demands and new instructions, control attention, impulsivity, and emotions (15, 16), and thus are very important in everyday life and learn- ing process. Data from studies involving patients with JME show a range of deficits in various ex- ecutive functions (6, 11–13) suggesting the impair- ment of frontal and prefrontal regions. Neuroimag- ing studies revealing subtle structural abnormalities in the prefrontal region (17–20) suggest a frontal lobe dysfunction in JME and even raise a question if JME is a truly generalized epilepsy syndrome. How- ever, results of the studies are inconsistent, and there is some evidence that slight abnormalities of frontal