title: Temporal lobectomy with delayed amnesia following a new lesion on the other side.
abstract: OBJECTIVE
  To describe a delayed severe complication of temporal lobectomy for intractable epilepsy.
  
  
  METHODS
  A case of amnesia occurring 24 years after surgery is described and five similar cases from the literature reviewed.
  
  
  RESULTS
  Mean age at surgery (5 right) was 40 years (19-62 years), 3 female. Four of five tested had impaired visual and verbal memory preoperatively but not sufficient to contraindicate surgery. Pathology was mesial temporal sclerosis in 3, 1 cavernoma, 1 dysembryoplastic neuroepithelial tumor (DNET) and 1 normal. Postoperatively, four were seizure free 3-12 years off medication and two continued with seizures. There was no unexpected postoperative memory change until incapacitating anterograde amnesia developed 1-24 years after surgery. In five patients, including ours, this followed definite or possible status epilepticus with new mesial temporal sclerosis on the opposite side in the four that were investigated by MRI. One patient developed a glioblastoma in the opposite temporal lobe.
  
  
  CONCLUSIONS
  Continuing or late recurrence of seizures from the remaining temporal lobe after temporal lobectomy can result in incapacitating amnesia if status epilepticus occurs. Other new lesions on the opposite side to surgery can have the same effect.
authors.forename: Andrea
authors.initials: A
authors.lastname: Salmon
authors.forename: Brent
authors.initials: B
authors.lastname: Hayman-Abello
authors.forename: Barbara
authors.initials: B
authors.lastname: Connolly
authors.forename: Richard S
authors.initials: RS
authors.lastname: McLachlan
mesh_terms: D020324:Amnesia, Anterograde / Q000503:physiopathology*; D000648:Amnesia, Retrograde / Q000503:physiopathology*; D038481:Anterior Temporal Lobectomy; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D007839:Functional Laterality; D059907:Functional Neuroimaging; D006624:Hippocampus / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000503:physiopathology*; D012008:Recurrence; D013997:Time Factors