Predictors of intellectual performance in adults with intractable 
temporal lobe epilepsy

Glosser, Guila; Cole, Lynne; French, Jacqueline; Saykin, Andrew J.; Sperling, Michael R.

doi:10.1017/s135561779700252x

Cited by 60 publications

(32 citation statements)

References 37 publications

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“…3). The finding that lower IQ is related to earlier age at onset of epileptic seizures is consistent with previous research (Strauss et al, 1995; Glosser et al, 1997, however, see Bjornaes et al, 2001; Thompson and Duncan, 2005) and suggests that a lower IQ level results from other factors (e.g., more severe epilepsy) with unemployment as the end result. The relationship between seizure control and employment may also be related to resumption of driving.…”

Section: Discussionsupporting

confidence: 91%

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

Dulay

York

Soety³

et al. 2006

Epilepsia

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Summary: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.

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Section: Discussionsupporting

confidence: 91%

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

Dulay

York

Soety³

et al. 2006

Epilepsia

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“…A core finding, clear from some of the earliest cognitive studies and routinely reported through the decades, is that an early age of onset of recurrent seizures is associated with a pernicious impact on a broad array of cognitive functions. This effect was reported as early as 192446 and subsequently confirmed in studies of adult patients with diverse seizure types,10,47–50 and even reported in neuropsychological studies of younger patients with complex partial and other types of seizures 51–53…”

Section: The Distributed Nature Of Cognitive Impairment In Mtlementioning

confidence: 54%

The Emerging Architecture of Neuropsychological Impairment in Epilepsy

Hermann¹,

Lin²,

Jones³

et al. 2009

Neurologic Clinics

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A new literature is now under way, one linking cognitive abnormalities directly to indices of structural, functional, metabolic, and other neurobiologic markers of cerebral integrity, independent of their association with clinical epilepsy characteristics. These trends are reviewed in this article. The focus is on temporal lobe epilepsy (TLE) as a model with which to address the core points because this form of localization-related epilepsy has been very carefully studied from both a cognitive and imaging standpoint. Some pertinent historical issues are touched on first, followed by more detailed reviews of the cognitive and neuroimaging abnormalities that have been found in TLE, followed by an overview of studies examining direct structure-function relationships in TLE and other epilepsies.

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“…This suggestion is in agreement with findings in several studies in intellectually unselected groups of patients (48–52). However, some studies failed to find a relation between duration of epilepsy and outcome (53–56). One reason for this discrepancy may be that many studies have examined linear relations only.…”

Section: Discussionmentioning

confidence: 99%

Resective Surgery for Intractable Focal Epilepsy in Patients with Low IQ: Predictors for Seizure Control and Outcome with Respect to Seizures and Neuropsychological and Psychosocial Functioning

et al. 2004

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Summary:Purpose: To investigate possible predictive factors for seizure control in a group of children and adults with low IQs (IQ, ≤70) who underwent resective surgery for intractable focal epilepsy and to study outcome with respect to seizures and neuropsychological functioning. We also studied psychosocial outcome in the adult patients.Methods: Thirty-one patients (eight children younger than 18 years) with a Wechsler Full Scale IQ of 70 or less underwent comprehensive neuropsychological assessments before and 2 years after surgery. Adults also completed the Washington Psychosocial Seizure Inventory (WPSI). Univariate analyses were used to identify variables differentiating between patients who became seizure free and those who did not. Pre-and postoperative test results were compared by t test for dependent samples.Results: Forty-eight percent of the patients became seizure free, 52% of those with temporal lobe resection and 38% of those with extratemporal resection. Only one variable was predictive for seizure outcome: duration of epilepsy. In one third of the patients, who had the shortest duration of epilepsy (<12 years), 80% became seizure free. Significant improvement was seen regarding vocational adjustment in adults (WPSI). Seizure-free adults improved their Full Scale IQ scores. No cognitive changes were found in seizure-free children or in patients who did not become seizure free. Conclusions: A good seizure outcome was obtained after resective surgery in patients with intractable focal epilepsy and low IQ, provided that treatment was done relatively shortly after onset of epilepsy. No adverse effects were seen on cognitive and psychosocial functioning.

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Predictors of intellectual performance in adults with intractable temporal lobe epilepsy

Cited by 60 publications

References 37 publications

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

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

The Emerging Architecture of Neuropsychological Impairment in Epilepsy

Resective Surgery for Intractable Focal Epilepsy in Patients with Low IQ: Predictors for Seizure Control and Outcome with Respect to Seizures and Neuropsychological and Psychosocial Functioning

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