Neuropsychiatric Symptoms of Epilepsy

11 Emotion Recognition
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Effect of Antiepileptic Drugs
Only few studies reported information about the number and types of antiepileptic
drugs (AED) used by patients during ER evaluation. Meletti et al. [ 28 ] grouped TLE
patients according to the number of AED taken (one, two, three, and more-AED
groups). No difference in ER scores was observed among the three groups. Then
they analyzed ER in TLE patients using a given AED with respect to TLE patients
that were not taking that particular AED observing that only the use of Phenobarbital
had a negative effect on emotion recognition abilities. Hlobil et al. [ 71 ] described
that fear recognition was significantly associated with the number of AED taken at
time of testing.
Emotion Recognition and Measures of Intelligence
To date few studies have evaluated formally the relationship between global intelligence
measures and emotion recognition in TLE. In these studies no significant
correlation emerged at least concerning facial expressions. Two studies, on the
other hand, documented a negative effect of low total and verbal IQ scores on
auditory emotion recognition. Overall, the available literature is not sufficient to
make a final judgment. At least with regard to the recognition of facial expressions,
the overall level of intelligence and education do not seem to have an
important role [ 28 , 29 , 33 ].
Emotion Recognition After Anterior Temporal Lobectomy
An important open question concerns the consequences (if any) of antero-medial
temporal resections on ER abilities in patients with an enduring temporal lobe epileptic
focus. Current literature shows that in patients with ATL there is a lack of
emotion recognition skills, with qualitative and quantitative characteristics apparently
similar to that observed in patients with pre-surgical TLE. Unfortunately,
however, there are currently only few studies that have investigated the longitudinal
changes before and after temporal lobectomy, that too in small groups or case
reports [ 45 , 46 , 55 , 72 , 73 ]. For this reason, it is not possible to determine the real
effect of temporal lobectomy in TLE patients. ER impairments, at least as facial
emotion labeling is concerned, are “on average” similar in severity to those observed
in patients with chronic TLE; however, the “average picture” observed after temporal
lobectomy is likely the result of improvement in some patients and worsening in
others. Indeed, some evidence exists that after lobectomy, and seizure-freedom,
patients can improve in ER [ 45 , 46 , 73 ]. Finally, a weakness, observed in some of
the studies, is the lack of clinical information pertaining to the surgical outcomes. In
other words, if after temporal lobectomy the patients studied were recovered from