Memory, Emotional and Vocational Impairments before and after Anterior Temporal Lobectomy for Complex Partial Seizures

• Published in: Epilepsia (Copenhagen) 2006-11, Vol.47 (11), p.1922-1930
• Main Authors: Dulay, Mario F., York, Michele K., Soety, Elizabeth M., Hamilton, Winifred J., Mizrahi, Eli M., Goldsmith, Ian L., Verma, Amit, Grossman, Robert G., Yoshor, Daniel, Armstrong, Dawna D., Levin, Harvey S.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Affective Symptoms - diagnosis; Affective Symptoms - epidemiology; Affective Symptoms - psychology; Anterior temporal lobectomy; Anterior Temporal Lobectomy - adverse effects; Anticonvulsants. Antiepileptics. Antiparkinson agents; Biological and medical sciences; Emotion; Employment; Epilepsy, Complex Partial - epidemiology; Epilepsy, Complex Partial - psychology; Epilepsy, Complex Partial - surgery; Female; Functional Laterality; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Male; Medical sciences; Memory; Memory Disorders - diagnosis; Memory Disorders - epidemiology; Memory Disorders - psychology; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Neuropathology; Neuropharmacology; Neuroprotective agent; Neuropsychological Tests - statistics & numerical data; Pharmacology. Drug treatments; Postoperative Complications - diagnosis; Postoperative Complications - epidemiology; Postoperative Complications - psychology; Preoperative Care; Retrospective Studies; Surgery outcome; Treatment Outcome; Unemployment - psychology; Unemployment - statistics & numerical data
• ISSN: 0013-9580; 1528-1167
• DOI: 10.1111/j.1528-1167.2006.00812.x

Purpose: To assess the pre‐ and postsurgical frequency of memory, emotional, and vocational impairments in patients who underwent anterior temporal lobectomy (ATL), and to assess the relationship between emotional disturbance and memory abilities after ATL. Methods: Retrospective analysis of data was performed on 90 patients with medically intractable complex partial seizures who underwent ATL between 1981 and 2003. Patients were evaluated an average of 5 months before surgery and 11.3 months after surgery. Results: A moderate to high frequency of memory impairment (44.4%; verbal or nonverbal), emotional disturbance (38.9%) and unemployment (27.8%) existed in the same individuals both before and after surgery. There were small to moderate rates of new onset memory (18.9%), emotional (11.1%), and vocational (7.8%) difficulties after surgery often regardless of seizure control outcome. Patients who underwent left‐ATL and had emotional disturbance after surgery had the lowest verbal memory test scores. Conclusions: Results highlight the importance of taking into account emotional status when assessing memory abilities after ATL. Results replicate the finding of moderate to high frequencies of memory impairment, emotional disturbance, and unemployment both before and after ATL. Results provide support for the rationale that cognitive, psychiatric and vocational interventions are indicated to mitigate the problems that exist before and persist after ATL.