Memory outcome in patients with medically intractable epilepsy following stereotactic laser amygdalohippocampectomy.

OBJECTIVE

To evaluate the impact of stereotactic laser amygdalohippocampectomy (SLAH) on verbal and visual memory functions in patients with intractable temporal lobe epilepsy (TLE) given that currently memory outcomes following SLAH are unclear with only scant conflicting findings.

METHODS

A retrospective review of demographic, imaging, and memory data in patients with medically intractable epilepsy (N = 30 patients; 16 Right Temporal Lobe Epilepsy [RTLE; 14 Left Temporal Lobe Epilepsy [LTLE]). Means, standard deviations, and reliable change analyses were computed for demographic variables and memory tests. Reliable change index (RCI) analyses were used to evaluate memory change.

RESULTS

Following left temporal surgery (LTS), 41.7% demonstrated stable verbal memory, while 58.3% showed declines in verbal memory. Inspection of visual memory performances revealed 77.8% also declined, while 11.1% remained stable and 11.1% improved. Post right temporal surgery (RTS) 33.3% demonstrated improved visual memory, 44.4% displayed stability, and 22.2% declined. Additionally, for RTS 77.8% displayed verbal memory performance stability, while 22.2% declined.

CONCLUSIONS

Current data indicates mixed outcomes. 58.3% of patients displayed verbal memory declines following LTE ablation and none displayed improvements. However, 33.3% of RTL ablation patients displayed visual memory improvements. This study offers further evidence of potential adverse outcomes and need for review of surgical approach and/or patient selection.