title: Memory, emotional and vocational impairments before and after anterior temporal lobectomy for complex partial seizures.
abstract: OBJECTIVE
  To assess the pre- and postsurgical frequency of memory, emotional, and vocational impairments in patients who underwent anterior temporal lobectomy (ATL), and to assess the relationship between emotional disturbance and memory abilities after ATL.
  
  
  METHODS
  Retrospective analysis of data was performed on 90 patients with medically intractable complex partial seizures who underwent ATL between 1981 and 2003. Patients were evaluated an average of 5 months before surgery and 11.3 months after surgery.
  
  
  RESULTS
  A moderate to high frequency of memory impairment (44.4%; verbal or nonverbal), emotional disturbance (38.9%) and unemployment (27.8%) existed in the same individuals both before and after surgery. There were small to moderate rates of new onset memory (18.9%), emotional (11.1%), and vocational (7.8%) difficulties after surgery often regardless of seizure control outcome. Patients who underwent left-ATL and had emotional disturbance after surgery had the lowest verbal memory test scores.
  
  
  CONCLUSIONS
  Results highlight the importance of taking into account emotional status when assessing memory abilities after ATL. Results replicate the finding of moderate to high frequencies of memory impairment, emotional disturbance, and unemployment both before and after ATL. Results provide support for the rationale that cognitive, psychiatric and vocational interventions are indicated to mitigate the problems that exist before and persist after ATL.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Bayor College of Medcine, Houston, Texas 77030, USA.
authors.forename: Mario F
authors.initials: MF
authors.lastname: Dulay
authors.forename: Michele K
authors.initials: MK
authors.lastname: York
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Soety
authors.forename: Winifred J
authors.initials: WJ
authors.lastname: Hamilton
authors.forename: Eli M
authors.initials: EM
authors.lastname: Mizrahi
authors.forename: Ian L
authors.initials: IL
authors.lastname: Goldsmith
authors.forename: Amit
authors.initials: A
authors.lastname: Verma
authors.forename: Robert G
authors.initials: RG
authors.lastname: Grossman
authors.forename: Daniel
authors.initials: D
authors.lastname: Yoshor
authors.forename: Dawna D
authors.initials: DD
authors.lastname: Armstrong
authors.forename: Harvey S
authors.initials: HS
authors.lastname: Levin
mesh_terms: D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D038481:Anterior Temporal Lobectomy / Q000009:adverse effects; D017029:Epilepsy, Complex Partial / Q000453:epidemiology / Q000523:psychology / Q000601:surgery*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011300:Preoperative Care; D012189:Retrospective Studies; D016896:Treatment Outcome; D014478:Unemployment / Q000523:psychology / Q000706:statistics & numerical data*