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Revue de neuropsychologie. Volume 3, Number 1, 11-22, Mars 2011, Article original

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Author(s) : Valérie Charbonnier, Arnaud Roy, Caroline Seegmuller, Agnès Gautier, Didier Le Gall

Summary : Executive Function (EF) encompasses the higher order cognitive capacities of planning, response inhibition, working memory, cognitive flexibility and social behavior. Frontal lobes, which are thought to subserve EF skills, are particularly vulnerable to lesions occurring in childhood [1] . Impairment of several aspects of EF, including cognitive and behavioural disorder, has been observed in frontal epilepsy. However, data remain sparse and EF profile of children with frontal epilepsy is still poorly characterized <\;td:cross-ref refid\="bib2" xmlns:td\="http://www.thomsondigital.com/xml/common/dtd">[2]<\;/td:cross-ref> . In this paper, we present a detailed single case study of the neuropsychological profile of a 10-year-old boy suffering from a symptomatic partial frontal lobe epilepsy caused by left superior frontal gyrus dysplasia. The epilepsy has appeared 4 years ago and remained pharmaco-resistant. A comprehensive neuropsychological assessment including EF was proposed. EF examination comprised classic, experimental and ecological tasks. Normative data for several of these tools were not available and were then compared to 10 healthy control children matched to the patient on age, sex and parental education level. Results indicated a preponderant impairment of cognitive aspects of EF, including more specifically planning and working memory disorders, whereas the affective dimension was spared. Questionnaires of executive dysfunction in everyday life filled out by the parents confirmed this neuropsychological profile. The clinical symptomatology of the patient can be linked to the dorso-lateral prefrontal localization of epileptogenic focus as this cerebral area is preferentially implicated in cognitive aspects of EF. This single case study is in accordance with the early vulnerability of frontal circuits in children, which is associated with an increased risk for learning disabilities, social and future professional integration difficulties.

Keywords : executive function, epilepsy, frontal lobe, child