Abstracts

RATIONALE: Anit-epileptic drugs (AEDs) are the primary treatment of choice for epilepsy (ES); however, approximately 1/3 of patients with ES do not respond to AEDs. For those patients, surgical options (surgical resection, vagus nerve stimulation implants) remain, but there are concerns for cognitive and psychological effects of surgical resection. This study examines change in cognitive and quality of life issues for individuals receiving either right or left temporal lobe resections for intractable epilepsy.
METHODS: Twelve individuals (50% female, M age 34, M years of education 12.75) received right-temporal lobe resection and 17 individuals (47.1% female, M age 31, M years of education 12.53) received left-temopral resection for treatment of epilepsy and were evaluated by the Neuropsychology program between March, 1995 and April, 2001.
RESULTS: Due to changes in assessment instruments over time and patient mortality, the sample size for comparison of pre-surgery and post-surgery data is variable. Using paired-sample t-tests, for R hemisphere resections, no differences were noted in general measures of intellectual functioning (N=7), general indices of memory (N=7) or for one measure of executive functions (N=12). Limited data using the WASI (N=3) did indicate an improvement for Full Scale IQ scores post-surgery. Overall psychological functioning (Washington Psychosocial Seizure Inventory)(N=5) was significantly improved (t = 6.81, p[lt].01) as was the Adjustment to Seizure subscale (t = 3.19, p[lt].05), despite the small sample size. For L hemisphere resections, no differences were noted in general measures of intellectual functioning (N=14), general indices of memory (N=15), or for a measure of executive function (N=16). Additionally, no significant differences were noted for measures of quality of life (N=9). Comparison of pre-surgery data for L & R hemisphere resections suggests a comparable level of performance across most measures, although R hemisphere patients did perform better than L hemisphere patients for a Performance index from the WAIS-R (Levene[ssquote]s Test for Equality of Variances, F = 9.508, p[lt].01).
CONCLUSIONS: No indication of adverse cognitive changes were demonstrated for this series of R and L temporal lobectomy patients. R hemisphere patients did tend to report a greater change in quality of life measures post-surgery than did L hemisphere patients. Additonally, there was the suggestion that L and R hemisphere patients do show some differences pre-surgery with respect to certain measures of general intellectual functions.