Abstracts

RATIONALE: There is the possibility that specific sets of preoperative neuropsychological findings might predict surgical outcome.
The objective of this work is to correlate specific preoperative neuropsychological findings with long-term surgical outcome in patients with TLE/ HS.
METHODS: We tentatively considered verbal memory (Vmem) standardized test batteries as probes of function of the language dominant (usually left) TL, and non-verbal memory tests (NVmem) as probes of function of the non-dominant (usually right) TL. Vmem and NVmem tests were thus applied to 91 consecutively operated patients with TLE/HS, followed up for a mean of 45 months, which conformed to one of the following 4 groups: (a) both Vmem / NVmem results within the normal range (WNR)(n=30); (b) both Vmem/ NVmem in the abnormal range(n=20); (c) Memory tests WNR in the side operated while abnormal on the contralateral side (n=18); (d) Memory tests abnormal in the operated side, while normal on the non-operated TL (n=23). The proportion of patients in each group achieving class I outcome, according to Engel[ssquote]s classification was noted.
RESULTS: Class I outcome was respectively achieved by 28/30 (93%) patients in group (a), 18/20 (90%) in group (b), 15/18 (83%) in group (c), and in 17/23 (73%) of those in group (d). Thus, a pattern of neuropsychological findings pointing to dysfunction of the contralateral TL did not predict poor surgical results when bona fide HS was unilaterally present in the operated side. Strinkingly, the least favorable outcome was actually observed in those patients in which both the HS and the memory neuropsychological dysfunction coincided in the same operated TL
CONCLUSIONS: Preoperative neuropsychological findings pointing to dysfunction of the mesial temporal structures contralateral to a well localized mesial temporal epileptogenic zone associated with clearcut HS does not predict unfavorable post-operative seizure outcome.
[Supported by: FAPERGS]