The effects of memory, extra-memorial functions, and neuro-imaging on the prognosis of operated and non-operated temporal lobe epilepsy patients

Abstract

Purpose: Epilepsy is a common disease effecting 0.5-1% of all community. 30-35% of epileptic patients stil have seizures even if they are on new antiepileptic drugs. The success rate of epilepsy surgery shows variability between 33 and 90% in drug resistant TLE patients. We aimed to evaluate memory and extra-memorial functions in operated and nonoperated TLE patients (for operated group presurgical and postsurgical). The relation between neuropsychological test results and age, sex, disease duration, frequency of seizures, focus of seizures, medication, neuroimaging methods and prognosis was investigated. Method: In this study we investigated files of 90 patients retrospectively and s prospectively who were diagnosed as TLE in Uludag University Department of Neurology, Neurology Clinic between 2002 and 2011. All patients were hospitalized in video-EEG unit of Neurology Department. All cases seizure follow-up, Video-EEG, cranial magnetic resonance imaging (MRI) and Pozitron Emission tomography (PET), neuropsychometric testing (NPT) were performed to all patients. 37 of these patients were performed amygdala hippocampectomy + anterior temporal lobec- tomy by neurosurgery department while remaining 53 patients were followed up with medical treatment. Results: As a result, video-EEG, MRI, PET and NPT showed similar results in terms of lateralization. The operated patients improved in memory and extra-memorial functions in the following controls. Verbal and visual memory tests, WMS mental control tests, attention, face recognize and visiospatial ability tests were sensitive to detect the disorders in relevant brain regions. Significant decrease at seizure frequency was found in the operated patients after surgery. Conclusion: Our findings showed significantly increase life quality in terms of reduced seizure frequency and beter cognitive functions.