2010
American Epilepsy Society Poster (Abst. 1.319)
Neuropsychological Testing of Hispanic Seizure Patients with Comprehensive Testing Developed and Normed on Hispanic Samples
Authors: G. Lancman, L. Myers, G. Vazquez and Kenneth Perrine
Rationale:
Neuropsychological testing helps in pre-surgical treatment planning by assisting in lateralization of the seizure focus. Previous research with English speakers shows that tests of naming and verbal memory are significantly worse in patients with left hemisphere (LH) onsets vs. right hemisphere (RH) onsets, but findings with Hispanic patients using screening batteries (e.g., the Neuropsychological Screening Battery for Hispanics, NeSBHIS) have not been promising. The current study examines the utility of more extensive standardized tests developed for and normed on Hispanic samples in differentiating patients with LH vs. RH seizure onsets.
Methods:
All of the neuropsychological reports on Hispanic pre-surgical epilepsy patients from 2003 to 2009 performed at the Northeast Regional Epilepsy Group were reviewed. Subjects were all self-identified as Hispanic and spoke Spanish as their primary language, and were all tested only in Spanish. All patients with unambiguous lateralized partial epilepsy confirmed by Video EEG monitoring and MRI and who proceeded to surgery were selected (n=38). Patients were administered the Ponton-Satz Naming Test, WHO/UCLA Auditory Verbal Memory Test, the Brief Intellectual Ability quotient (BIA) from the Bateria III Woodcock Munoz (BIA) & Achievement subtests (reading comprehension, spelling and mathematical operations), Continuous Visual Memory Test, Phonemic (FAS) and Categorical (Animal) Fluency, Grooved Pegboard, and mood inventories (Beck Anxiety Inventory and Beck Depression Inventory-Second Edition). Student’s t-test for the major scores from each test was performed for LH vs. RH onsets.
Results:
Descriptive statistics of the sample yielded a mean (SD) age at testing=42.2 (15.7), age at onset= 20.1 (19.3), education= 10.1 (3.0), 25 women, and 5 non-right-handers. The results showed that LH onset patients performed significantly worse than RH onset patients for the BIA Verbal Ability (78.8 v. 88.4, p=.009) and Verbal Comprehension (78.9 v. 90.3, p=.004) scales. The Ponton-Satz was also significantly different between LH v. RH onset patients (14.8 v. 20.9, p=.001).
Conclusions:
Use of a comprehensive battery of neuropsychological tests developed for and normed on Hispanic samples proves useful in lateralizing patients with left vs. right hemisphere seizure onsets, equivalent to test batteries for English speaking patients. Prior negative findings with the NeSBHIS may relate to the use of only brief screening measures (average of 90 minutes versus a 3-4 hour assessment) or outdated (e.g., Escala de Inteligencia Wechsler para Adultos-EIWA) subtests compared to more thorough batteries normed on a more current and broad sample of Hispanics.