title: Poor presurgical performance on both verbal and visual memory measures is associated with low risk for memory decline following left temporal lobectomy for intractable epilepsy.
abstract: Studies have shown a lower risk for verbal memory decline following dominant anterior temporal lobectomy (ATL) among patients with poor, presurgical verbal memory scores. It is unclear however, if the risk of decline is increased in patients who also have reduced visual memory. Objective and subjective memory outcome following left ATL was examined in twelve patients with reduced presurgical visual and verbal memory scores. Only one patient demonstrated a meaningful decline in memory scores, with a decline in visual memory following surgery. Presurgically, this patient demonstrated poor memory bilaterally on Wada testing and small discrepancy in hippocampal volumes. She was also one of two patients who continued to have seizures post-surgery. This preliminary study suggests that patients with unilateral, left TLE and poor verbal and visual memory are unlikely to show meaningful memory declines following left ATL, particularly if they demonstrate expected patterns on Wada testing, hippocampal volume discrepancy (left < right), and postsurgical seizure-freedom.
authors.affiliation: Cleveland Clinic Epilepsy Center, Neurological Institute, Cleveland, OH 44195, USA. buschr@ccf.org
authors.forename: Robyn M
authors.initials: RM
authors.lastname: Busch
authors.forename: Jessica S
authors.initials: JS
authors.lastname: Chapin
authors.forename: Gopalan
authors.initials: G
authors.lastname: Umashankar
authors.forename: Beate
authors.initials: B
authors.lastname: Diehl
authors.forename: Daniel
authors.initials: D
authors.lastname: Harvey
authors.forename: Richard I
authors.initials: RI
authors.lastname: Naugle
authors.forename: Dileep
authors.initials: D
authors.lastname: Nair
authors.forename: Imad M
authors.initials: IM
authors.lastname: Najm
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000654:Amobarbital / Q000008:administration & dosage; D038481:Anterior Temporal Lobectomy / Q000009:adverse effects*; D017536:Carotid Artery, Common; D004569:Electroencephalography; D004827:Epilepsy / Q000523:psychology* / Q000601:surgery*; D005260:Female; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007261:Infusions, Intra-Arterial; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory / Q000502:physiology*; D008569:Memory Disorders / Q000209:etiology* / Q000473:pathology / Q000523:psychology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000473:pathology / Q000523:psychology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014705:Verbal Behavior / Q000502:physiology*; D014796:Visual Perception / Q000502:physiology*
chemical_list: D006993:Hypnotics and Sedatives; D000654:Amobarbital