title: Memory outcomes in mesial temporal lobe epilepsy surgery.
abstract: BACKGROUND
  Decline in verbal memory after dominant mesial temporal lobe surgery is a concern. Outcomes primarily reported by group data analysis do not address issues of practice effects and measurement errors and also do not provide information about individual meaningful change after surgery. Reliable Change Indices (RCI's) are regarded to be robust statistical methods for reporting individual change and have not been hitherto derived in patient populations in India.
  
  
  OBJECTIVE
  Report memory outcomes for patients after surgery using group data as well as RCI score analyses using RCI scores derived in a control patient population.
  
  
  METHODS
  Retrospective data analysis of 106 selected patients who underwent Anterior Temporal Lobectomy (ATL) surgery. RCI scores derived from a control group of 44 non-operated patients. Outcomes based on score shifts on the various measures of two verbal and visual memory tests.
  
  
  RESULTS
  Group mean score analysis revealed no significant shifts in verbal or visual memory scores after left ATL, but significant improvements in verbal memory after right ATL. RCI score analysis revealed decline and improvements in a small percentage of patients for both left and right ATL groups. Percentage of patients showing decline was much less than reported in western literature although percentage improved was comparable.
  
  
  CONCLUSIONS
  Differences in decline percentage may be due to RCI scores and clinical characteristics of our sample (impaired pre-operative functioning, majority seizure free post surgery, moderate hippocampal sclerosis, early onset, long duration of seizures).
  
  
  CONCLUSIONS
  Group analyses mask individual change. Therefore, to report memory outcomes and counsel patients about relative risk-benefits of surgery, RCI scores derived from our patient populations should be used.
authors.affiliation: Department of Neurology, Comprehensive Epilepsy Care Program, Seth G.S Medical College and King Edward Memorial (K.E.M) Hospital, Parel, Mumbai 400012, India. Electronic address: shahurvashi100@gmail.com.
authors.forename: Urvashi
authors.initials: U
authors.lastname: Shah
authors.affiliation: Department of Neurology, Seth G.S. Medical College and King Edward Memorial (K.E.M) Hospital, Parel, Mumbai 400012, India. Electronic address: aishanibdesai@gmail.com.
authors.forename: Aishani
authors.initials: A
authors.lastname: Desai
authors.affiliation: Department of Neurology, Comprehensive Epilepsy Care Program, Seth G.S Medical College and King Edward Memorial (K.E.M) Hospital, Parel, Mumbai 400012, India. Electronic address: ravatsh@yahoo.com.
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Ravat
authors.affiliation: Department of Neurosurgery, Comprehensive Epilepsy Care Program, Seth G.S Medical College and King Edward Memorial (K.E.M) Hospital, Parel, Mumbai 400012, India. Electronic address: dmuzumdar@hotmail.com.
authors.forename: Dattatraya
authors.initials: D
authors.lastname: Muzumdar
authors.affiliation: Department of Neurology, Seth G.S. Medical College and King Edward Memorial (K.E.M) Hospital, Parel, Mumbai 400012, India.
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Godge
authors.affiliation: Department of Psychiatry, Comprehensive Epilepsy Care Program, Seth G.S. Medical College and King Edward Memorial (K.E.M) Hospital, Parel, Mumbai 400012, India. Electronic address: drneenas@yahoo.com.
authors.forename: Neena
authors.initials: N
authors.lastname: Sawant
authors.affiliation: Department of Neurology, Seth G.S. Medical College and King Edward Memorial (K.E.M) Hospital, Parel, Mumbai 400012, India. Electronic address: mayuri.dusc@gmail.com.
authors.forename: Mayuri
authors.initials: M
authors.lastname: Jain
authors.affiliation: Department of Neurology, Seth G.S. Medical College and King Edward Memorial (K.E.M) Hospital, Parel, Mumbai 400012, India. Electronic address: neeraj2you@gmail.com.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Jain
mesh_terms: D000328:Adult; D038481:Anterior Temporal Lobectomy; D004833:Epilepsy, Temporal Lobe / Q000523:psychology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014706:Verbal Learning
keywords: Epilepsy surgery; Memory; Mesial temporal lobe; Outcome; Reliable change index