Memory in patients with drug-responsive mesial temporal lobe epilepsy and hippocampal sclerosis.
OBJECTIVE
Mesial temporal lobe epilepsy associated with hippocampal sclerosis (MTLE-HS) is the most common of the antiepileptic drug (AED)-resistant seizure syndromes that are remediable mostly with surgery, although a small group of patients have benign prognosis with fewer seizures. Material-specific memory impairment is an important feature in these patients and may be related to both the structural abnormality and the frequent seizures. In this study, we investigated the relation between memory deficit and HS by taking seizure frequency into account.


METHODS
The patients were evaluated according to a standard protocol and divided into two groups, considering their response to AEDs: the good-responder group (GRg, n = 18) and the pharmacoresistant group (PRg, n = 95). They were administered a neuropsychological test battery that included verbal and nonverbal memory tests, compared with each other and with a normal control group (n = 29). The responder group was evaluated by the same battery once again (mean, 23 months; SD, 8.25; range, 14-38 months).


RESULTS
Both GR and PR patient groups had poorer memory than the normal controls in all memory tests (p < 0.05). However, the comparison of GRg with PRg revealed that only the digit-span test was significantly worse in PRg (p = 0.0061), and no difference was found in any other memory scores. The reevaluation of the GRg showed no significant difference between the first and second evaluation.


CONCLUSIONS
We concluded that the memory impairment in patients with MTLE-HS was permanent and might be related to the direct effect of HS itself. Therefore patients with good response to AEDs can be used as a model for investigating the memory problems in patients with MTLE-HS.
Ozkara
Ciğdem
C
Department of Neurology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey. cigdemoz@anet.net.tr
Hanoğlu
Lütfü
L
Keskinkiliç
Cahit
C
Yeni
Naz
N
Aysal
Fikret
F
Uzan
Mustafa
M
Ozyurt
Emin
E
Karaağaç
Naci
N
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D001927:Brain Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D004833:Epilepsy, Temporal Lobe / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D012598:Sclerosis; D016896:Treatment Outcome
D000927:Anticonvulsants