Document Detail


Memory and intelligence outcome following surgery for intractable temporal lobe epilepsy: relationship to seizure outcome and evaluation using a customized neuropsychological battery.
MedLine Citation:
PMID:  15710297     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The main objectives of this prospective study were to (1) assess memory and intelligence outcome following surgery for intractable temporal lobe epilepsy, (2) correlate this with seizure outcome and side of surgery, and (3) perform (1) and (2) using an indigenously developed battery customized to the Indian population. Prior to use in our epilepsy surgery program, the test-retest and interexaminer variance reliability of this battery had been established in both normal and cognitively compromised populations. The memory scores were overall rather than material-specific. The battery was administered to right-handed adults undergoing surgery for intractable temporal lobe epilepsy without any evidence of opposite temporal lobe abnormality, both presurgery and postsurgery at a mean follow-up of 8 months. Twenty-five consecutive patients were included; 13 underwent right and 12 underwent left temporal surgery. Seizure outcome was assessed using Engel's classification. Among 13 patients who underwent right temporal surgery, although 4 patients with poor seizure outcome had insignificant changes in scores, 7 of 9 patients with good seizure outcome exhibited considerable (> 20% over preoperative) improvement in their memory and intelligence scores. Statistical analysis using Student's t test and the Mann-Whitney test revealed that the patients who underwent right temporal surgery with good seizure outcome had significant improvement in both memory (P = 0.007) and intelligence (P = 0.043) scores compared with those with poor seizure outcome. In contrast, patients who underwent left temporal surgery had no significant change in cognitive scores irrespective of seizure outcome. Cognitive improvement seems to occur in patients with good seizure outcome following nondominant temporal lobe surgery for intractable epilepsy with no evidence of pathology in the opposite temporal lobe. The same finding was not observed in patients undergoing left temporal surgery.
Authors:
Sujoy K Sanyal; P Sarat Chandra; Surya Gupta; Manjari Tripathi; V P Singh; Satish Jain; M V Padma; V S Mehta
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Epilepsy & behavior : E&B     Volume:  6     ISSN:  1525-5050     ISO Abbreviation:  Epilepsy Behav     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-02-15     Completed Date:  2005-05-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100892858     Medline TA:  Epilepsy Behav     Country:  United States    
Other Details:
Languages:  eng     Pagination:  147-55     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi 110 029, India.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Cognition / physiology
Epilepsy, Temporal Lobe / physiopathology*,  surgery
Evaluation Studies as Topic
Female
Follow-Up Studies
Functional Laterality
Humans
Intelligence / physiology*
Male
Memory / physiology*
Middle Aged
Neuropsychological Tests*
Prospective Studies
Psychosurgery / methods
Reproducibility of Results
Seizures / physiopathology,  surgery
Temporal Lobe / surgery
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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