الفهرس 
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Abstract
SUMMARY AND CONCLUSIONS
SUMMARY
The aim of this work is to evaluate the autonomic
manifestations and the study of the psychiatric and the
psychometric manifestations in the complex partial
seizures and the primary (idiopathic) grand mal epilepsy.
The study of this thesis was done on two epileptic
groups: the first group includes 50 patients suffering
clinically from complex partial seizures and the second
group includes 50 patients suffering clinically from
primary grand mal epilepsy. All patients were selected to
fulfill the criteria mentioned in details in the ”SUBJECT
AND METHOD” section of this thesis_
A 11 patients in each group were subjected to the
following:
1- Clinical assessment include:
(a) Thorough history taking.
(b) A detailed conducted neurological examination.
ec) A detailed and throughly conducted psychiatric
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examination with special emphasis on the cognitive
and mental functions.
(d) Physical examination includes all body systems and
routine investigations when needed.
(e) Fu 11 ep ilepsy sheet tak 1ng. (The sheet of Ep i1epsy
Outpatient Clinics of Kasr El-Aini Hospital)
2- Electroencephalographic (EE6) recording for vertification
of diagnosis •• detection of the laterality of
the focus and its correlation to the cognitive
manifestations.
3- Computed Axial Tomography to detect any brain lesions.
4- Evaluation of the autonomic changes in both patients
groups by:
(a) Clinical examination to detect blood pressure.
respiratory and heart rate changes. dizziness.
fainting. sweating. flushing ...etc.
(b) Autonomic tests include response of blood pressure
to stand and to stress.
(c) Electrocardiographic (EEG) screening to detect
specific changes in its various components.
5- Psychometric assessment by:
(a) Wechsler-Adult Bellevue Intelligence Scale (Arabic
version) to detect intellectual and momory changes.
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(b) Middlesex Hospi-tal Ques-tionnaire (Arabic version)
to demonstrate abnormal personality traits of
anxiety. phobia. obsessional ism. psychosomatic.
depression and hysteria.
(c) Minnesota Multiphasic Personality Inventory (Arabic
version) t.o demonstrate abnormalities of specific
selected scales of schizophrenia. paranoia. and
psychopathy.
Act.ual statistical analysis of t.he resulting data
using specific computer program revealed the results which
were mentioned in details in the ”RESULTS” section of this
thesis.
The following generalization can be made:
1- Autonomic manifestations:
(a) Dizziness. fainting and impotence occure more
significantly in the CPS group than in t.he GME
group.
(b) Abnormal response of blood pressure to stand and to
stress occure more significantl y in the CPS group
than in the GME group.
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(c) Two specific features of the ECG. arrhythmia and
prolonged QT interval occure more in the CPS group.
However no significarit difference in various
components of the EeG between the two groups.
2- Psychiatric and psychometric manifestations:
(A) Wechsler-Bellevue Intelligence Scale:
- There is no a significant difference between the CPS
and the GME groups on the different subscales of the
WAI S except on the information and the digit span
subscales being lower in the CPS group. The
different I.Q. scores of both groups lie in the below
average level of the standards. The different 1.0.
scores of the GME group were better than that of the
CPS group.
- I.Q. values seem to be differentially related to the
laterality of the focus. Patients with left
hemispheric focus tended to have the lower verbal I.Q
values. while those with right hemispheric focus have
the lower performance I.Q. values.
There is a positive significant correlation between
long duration of epilepsy. high frequency of
ep; leptic fits. incidence of status epilepticus. and
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theEEG abnormalities on one hand and the development
of cognitive and intellectual deterioration on the
other hand.
- There is a negative significant correlation between
momory subscales of WAIS. and different 1.05 on one
hand and the duration of epilepsy. frequency of
epileptic fits and the incidence of statue epileptcus
on the other hand.
(8) Middlesex Hospital Questionnaire:
- There is a significant difference between the CPS and
the 6ME groups on the anxiety. psychosomatic and
depressive traits. being higher in the CPS group.
The right hemispheric focus subgroup has the
significantly higher means on, the anxiety. and
depressive scales of the CPS group and on the
anxiety and psychosomatic scales of the GME group.
There is a positive correlation between the duration
of epilepsy and the frequncy epileptic fits on one
hand and the development of neurotic disorders on the
other hand.
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(el Minnesota Multiphasic Personality Inventory:
_ There is no significant difference between the CPS
and the GME groups on the selected personality traits
of schizophrenia. paranoia and psychopathy.
The incidence of schizoid and psychopathic personalit.
y t.rait.were significantly higher in the left
hemispheric focus subgroup.
There is no a significant. correlation bet.ween the
durat.ion of epilepsy and the frequency of epileptic
fits on one hand and t.he development of personality
t.raits of the MMPI on t.he other hand.
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epilepticus and abnormal electrical activity are
significantly correlated with limitations of cognitive
abilities (decrease of I.Qs. and increase of deterioratrion
indices).
(7) There is a correlation between more EEG lateralization
to the left hemispheric side of the brain and
lowering of the verbal I.Q.
(8) There is also, a significant correlation between more
incidence of right sided hemispheric foci and more
lowering of the performane I.Q.
(9) There is a significant difference between both groups
on the anxiety, psychosomatic and depressive traits of
Middlesex Hospital Questionnaire, the CPS group showed
higher scores than the GMf group.
(10) The duration of epilepsy. frequency of fits and the
EEG laterality are significantly corrlated with more
incidence of neurotic traits.
(11) The right hemispheric focus subgroup has the
significantly worse (higher) scores on the anxiety and
depressive scales of the CPS group and on the anxiety
and psychosomatic scales of the GME group.
(12) There is no significante difference be+.ween bo+.h
groups on the schizophrenic. pranoia. and psychopathic
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scales of
Inven~ory.
(13) These personali~y ~rai~s were not significantly
correla~ed with the duration of epilepsy and the
frequency ofits but the incidence of schizoid and
psychopathic traits were significantly higher in the
lef~ hemispheric focus group.
(14) further s~udies are recommended to uncover the
underlying aetiological factors of these autonomic
changes, intellectual deterioration and psychiatric
manifestations of epilepsy whether it ;s due to ictal
or interictal brain activities, an effect of prolonged
antiepileptic drugs or diffuse brain damage.
the Minnesota Multiphasic Personality