Effects of Anterior Temporal Lobectomy for Mesial Temporal Lobe Epilepsy on Intellectual and Memory Functions: 1-Year Follow-up

J Korean Neurol Assoc > Volume 24(4); 2006 > Article

Journal of the Korean Neurological Association 2006;24(4): 347-355.

내측두엽간질 환자에서 전측두엽절제술이 지능과 기억기능에 미치는 효과: 1년 추적

김홍근, 이상도a 손은익b 김지언c

대구대학교 재활과학대학 재활심리학과, 계명대학교 의과대학 신경과학교실a, 신경외과학교실b, 대구가톨릭대학교 의과대학 신경과학교실

Effects of Anterior Temporal Lobectomy for Mesial Temporal Lobe Epilepsy on Intellectual and Memory Functions: 1-Year Follow-up

Hongkeun Kim

Department of Rehabilitation Psychology, Daegu University, College of Rehabilitation Science, Daegu; Departments of Neurologya and Neurosurgeryb, Keimyung University, College of Medicine, Daegu; Department of Neurology, Catholic University of Daegu, College of Medicinec, Daegu, Korea

Abstract

Background: The aim of this study was to identify factors predicting intellectual and memory changes following anterior temporal lobectomy (ATL) for mesial temporal lobe epilepsy (TLE).
Methods: The sample consisted of 31 patients who underwent ATL for treatment of medically intractable TLE. All patients were administered intellectual and memory tests preoperatively and postoperatively.
Results: All statistically significant intellectual and memory changes at 1-year follow-up were in the direction of improvement. Left vs. right ATL had significantly differential effects on verbal intelligence and verbal memory, reflecting greater decline (or less improvement) following a left ATL. A later onset age of seizures, an older age at surgery, and a higher presurgical cognitive performance predicted a greater cognitive decline following an ATL.
Conclusions: At 1-year after ATL, most cognitive functions showed either no significant changes or significant changes in a favorable direction. Decreased verbal functions following a left ATL was the area of greatest potential neuropsychological morbidity associated with ATL. Greater cognitive decline following ATL was predicted by later onset age of recurrent seizures, older age at time of surgery, and higher presurgical cognitive performance.KeyWords:Temporal lobe epilepsy, Anterior temporal lobectomy, Epilepsy surgery, Intelligence, Memory