IQ AND MEMORY SUBTESTS ON PRESURGICAL NEUROPSYCHOLOGICAL EVALUATION DO NOT PREDICT SEIZURE OUTCOME IN MESIAL TEMPORAL LOBE EPILEPSY SURGERY
Abstract number :
1.460
Submission category :
Year :
2003
Submission ID :
1788
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Sara R. Rosset, Karinne O. Rezek, Erica R. Coimbra, Roger Walz, Vera C. Terra-Bustamante, Veriano Alexandre, Jr., Tonicarlo R. Velasco, Joao A. Assirati, Jr., Carlos G. Carlotti, Jr., Antonio C. Santos, Americo C. Sakamoto Neurology, Psychiatry and Clinic
Mesial temporal lobe epilepsy related to hippocampal sclerosis (MTLE-HS) is the most common surgically remediable epileptic syndrome. Anterior and mesial temporal lobectomy is a safe and effective treatment for medically intractable MTLE-HS. the literature regarding prognostic factors for surgical outcome of MTLE-HS is often contradictory. We investigated the predictive value of the pres-surgical neuropsychological performance in the post-operative outcome of MLTE-HS patients.
We included 191 consecutive patients surgically treated for MTLE-HS between 1995-2000, 93 males, 98 females, mean age of 34.9 yrs. According to the surgical outcome, patients were classified in two groups: A) Seizure-free group (Engel class I); and B) Non-seizure-free group (Engel II to IV). The clinical, demographic, neuroimaging, neurophysiologic and cognitive performance (IQ, Visual Reproduction I, Visual Reproduction II [ndash] 30 minutes, Logical Memory I, and Logical Memory II [ndash] 30 minutes) were analyzed.
There were no differences among the 3 tests and post-surgical seizure outcome (p [gt] 0.5). Univariate analysis indicated that patients with lower RVLII disclosed higher risk to persist with seizures (OR 2.63, CI 95% 1.195 [ndash] 5.81, p = 0.14). After the multiple logistic regression analysis adjusted for clinical, neuroimaging and neurophisiological imbalances, this lower performance in the RVLII did not show significant association with post-surgical seizure outcome (OR = 2.69, IC 95% 0.78 [ndash] 9.29, p = 0.12).
Cognitive performance in the presurgical neuropsychological tests did not show association with post-surgical seizure outcome in a consecutive group of MTLE-HS.
[Supported by: Apoio FAPESP, FAEPA, CNPq.]