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Published online before print September 10, 2008, doi:10.1212/01.wnl.0000319699.04265.fd)
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NEUROLOGY 2008;71:1319-1325
© 2008 American Academy of Neurology

Improvements in memory function following anterior temporal lobe resection for epilepsy

Sallie Baxendale, PhD, Pamela J. Thompson, PhD and John S. Duncan, FRCP

From the Department of Clinical and Experimental Epilepsy, Institute of Neurology UCL, Queen Square, London, UK.

Address correspondence and reprint requests to Dr. Sallie Baxendale, Department of Neuropsychology (Box 37), National Hospital for Neurology & Neurosurgery, Queen Square, London, WC1N 3BG UK sallieb{at}ion.ucl.ac.uk

Background: While up to a third of patients may experience a decline in memory following an anterior temporal lobe resection (ATL) for epilepsy, between 10 and 20% may experience a postoperative improvement in function. The aim of this study was to examine the preoperative characteristics of these patients.

Methods: Logistic regression analyses were used to determine which variables influenced postoperative memory improvement following ATL on standardized memory tests in 237 patients with unilateral hippocampal sclerosis (105 right; 132 left).

Results: A total of 22% of the right ATL and 9% of the left ATL group demonstrated a significant postoperative improvement in verbal learning. A total of 9% of the right ATL and 16% of the left ATL group demonstrated a significant postoperative improvement in visual learning. In the R ATL group, postoperative improvements in verbal learning were associated with poor preoperative verbal learning, a shorter duration of epilepsy, higher scores on the visual learning task, and an older age at the time of surgery. In the L ATL group, postoperative improvements in visual learning were associated with poor preoperative visual learning, a shorter duration of epilepsy, and a higher IQ. Postoperative improvements in memory functions associated with the ipsilateral temporal lobe were not associated with demographic or epilepsy-related variables.

Conclusions: Memory deficits normally associated with the function of the contralateral temporal lobe in patients with unilateral hippocampal sclerosis may improve postoperatively in patients with a shorter duration of epilepsy and the cognitive capacity to develop compensatory strategies.

Abbreviations: AMIBP = Adult Memory and Information Processing Battery; ATL = anterior temporal lobe resection; HS = hippocampal sclerosis; ILAE = International League Against Epilepsy; LTL = left temporal lobe; RTL = right temporal lobe.

Editorial, page 1302

e-Pub ahead of print on September 10, 2008, at www.neurology.org.

Disclosure: The authors report no disclosures.

Received November 21, 2007. Accepted in final form April 25, 2008.


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