Abstracts

RATIONALE: Postoperative decline in verbal memory has been demonstrated for some adults and adolescents following left temporal lobectomy (TLy). Szabo et al. (1998) reported a decline in delayed verbal recall for 10 preadolescent children regardless of side of surgery, as well as a differential effect on immediate verbal recall according to pathology. These findings have implications for understanding memory morbidity and memory functioning in children. For comparative purposes, results of verbal and figural memory testing are therefore presented for children who had temporal TLy at this institution.
METHODS: Twelve children, 5 to 10 years of age (mean 7.3), had comprehensive pre and postoperative neuropsychological assessment that included tests of intelligence and memory. Eight had left TLy, 4 right, and groups did not differ in preoperative Full Scale IQ (mean 81.0). Two children were left-handed and had right hemisphere speech via IAP. Four had tumors and four had pathology that included mesial temporal sclerosis (MTS+). Postoperative assessments were done ~12 months (mean 14.3, SD 5.1) after surgery. Memory tests were the [underline]Rey AVLT[/underline] and [underline]WRAML[/underline]: Picture Memory, Design Memory, Story Memory, and Sound Symbol. Standard scores for immediate and delayed recall were compared via three sets of 2 x 2 ANOVA with surgical status (pre vs. post) the within subject variable and side of surgery (right vs. left), preoperative level of memory performance (high vs. low), or pathology (tumor vs. MTS+) between subject variables.
RESULTS: Analyses showed no decline in intelligence or memory following TLy regardless of side of surgery or preoperative level of verbal or figural memory. There was, however, a tendency (p=.10) for children with MTS+ to show a postoperative decline in delayed story recall. There also were preoperative differences in Performance IQ and AVLT learning/recall according to side of surgery. Children with right TLy had lower preoperative Performance IQs than children with left TLy (68.4 vs. 87.6), while those with left TLy performed poorer on AVLT Learning and immediate recall than those with right TLy.
CONCLUSIONS: As found by Szabo et al., some preadolescent children who undergo TLy may have short-term postoperative memory morbidity that is a function of pathology (MTS+[gt]tumor). Whether this morbidity is specific to verbal memory, side of surgery, gender, and/or other factors unique to childhood remain to be determined, as do the long-term consequences of memory morbidity for academic learning and quality of life.