Abstracts

Rationale: Temporal lobe epilepsy (TLE) is the most commonly diagnosed focal epilepsy. Temporal lobe resection successfully controls medically intractable seizures in 60 to 85% of patients. However, post-surgical memory loss remains a significant risk. Risk of memory loss is increased among patients with intact pre-surgical verbal memory and absence of ipsilateral hippocampal abnormality. Despite continued efforts to predict outcome, significant decline in memory continues to occur. The purpose of this study was to further evaluate the magnitude in change scores among selected patients with right or left TLE. Methods: The study included review of epilepsy patients completing pre and post-surgical evaluations for medically refractory epilepsy. Participants: Nineteen subjects were identified that met study inclusion and exclusion criteria. There were 11 participants with LTLE and 13 participants with RTLE. Measure(s). Comprehensive neuropsychological evaluations pre-surgically, and an average of 10 months after tailored anterior temporal lobectomy (ATL). Results from MRI, V-EEG, Intracarotid Amytal (Wada's) test, neuropathology,and QUOLIE will be included. Results: The mean age of the LTLE sample was 39 years old (SD= 10.7) with 13.0 years of education. The mean age of the RTLE group was 35 years old (SD= 12.3) with 15.1 years of education. Education and FSIQ differed between groups (p<0.05) and were used as covariates in subsequent analyses. Prior to surgery, there was a significant interaction in which subjects with LTLE scored worse on verbal memory scores than patients with RTLE (p<.05). Alternatively, There was no difference between subjects with RTLE and LTLE on visual memory measures (p>.05). MANCOVA found a significant decline in verbal memory for subjects status-post left ATL while subjects status-post right ATL exhibited no change. Conversely, visual memory scores did not differ between LTLE and RTLE subjects. There was no change following right or left ATL in visual memory scores. Performance on Wada’s test and pre-surgical memory scores were independent predictors of post-surgical memory outcome. Conclusions: These data further support observations that presurgical neuropsychological data are valuable in predicting post-surgical memory outcome. Presurgially, the LTLE group performed worse on verbal memory tests than subjects with RTLE, and post operative decline was greater for the LTLE group.