Abstracts

Studies have shown limited decline in verbal memory scores following dominant temporal resection among patients with poor presurgical verbal memory scores. However, it is unclear if risk of decline is increased in patients with poor presurgical scores on both verbal and visual memory measures due to a hypothesized limited functional reserve. This study sought to examine postoperative memory outcome following left anterior temporal lobectomy (ATL) in patients with reduced presurgical visual as well as verbal memory., A retrospective review of our center[apos]s comprehensive epilepsy database was conducted. Patients were included in the study if they 1) had been diagnosed with unilateral left temporal lobe epilepsy (TLE) due to left hippocampal sclerosis; 2) underwent left ATL for treatment of seizures, 3) had preoperative standard scores of less than 80 on both verbal and visual delayed memory indices; 4) had Full Scale IQ scores greater than 70; and 5) were right-handed or confirmed as left hemisphere dominant for language on Wada testing. Twelve patients met inclusion criteria for the study. Changes in WMS-III verbal and visual delayed memory scores following left ATL were examined as well as presurgical EEG and MRI findings, hippocampal volumes, Wada test results, and seizure outcome., No patients demonstrated a reliably meaningful change in delayed verbal memory score following left ATL. However, 3 patients showed significant changes in visual delayed memory scores. One patient showed a significant decline (Patient 2) whereas 2 patients demonstrated significant improvements. Patient 2 had poor memory bilaterally on Wada testing. Only one other patient demonstrated better memory performance following right versus left injection. Other patients showed the expected pattern. Although Patient 2[apos]s typical automotor seizures did not recur, she began having seizures arising from the left occipito-parietal region approximately 6 months following surgery that included visual and auditory auras. Only one other patient was not seizure-free following surgery. Patient 2[apos]s data were also notable in that the discrepancy between her right and left hippocampal volumes prior to surgery was rather small. Only 2 other patients demonstrated a small discrepancy in hippocampal volumes. We believe these factors, in combination, contributed to Patient 2[apos]s postsurgical visual memory decline., This preliminary study suggests that patients with unilateral left TLE and both verbal and visual memory difficulties are not likely to demonstrate reliably meaningful declines in memory functioning, verbal or visual, following left ATL.,