Presurgical neuropsychological characteristics in epilepsy patients with left temporal lobe encephaloceles compared with left mesial temporal sclerosis
Abstract number :
385
Submission category :
11. Behavior/Neuropsychology/Language / 11A. Adult
Year :
2020
Submission ID :
2422730
Source :
www.aesnet.org
Presentation date :
12/6/2020 12:00:00 PM
Published date :
Nov 21, 2020, 02:24 AM
Authors :
Niyatee Samudra, Vanderbilt University Medical Center; Monica Jacobs - Vanderbilt University Medical Center; Joseph Aulino - Vanderbilt University Medical Center; Bassel Abou-Khalil - Vanderbilt University Medical Center;
Rationale:
Temporal lobe encephaloceles (TE) are increasingly recognized as a cause of drug-resistant temporal lobe epilepsy. Improved recognition of these lesions offers an opportunity to treat them with a limited resection sparing the hippocampus. However, as they can be difficult to identify on imaging, additional clues pointing to the diagnosis can be helpful. We sought to understand the baseline cognitive/neuropsychological profile in patients with left temporal lobe epilepsy caused by encephaloceles compared to that caused by mesial temporal sclerosis (MTS).
Method:
Neuropsychological testing, including language (semantic and phonemic fluency and naming), verbal memory, IQ, and executive function measures were compared across two groups (five patients with left temporal lobe encephaloceles and five age and gender-matched patients with left MTS). Other clinical variables related to cognition, including patient age, language lateralization, electroencephalographic characteristics, epilepsy duration, and factors related to anti-seizure medication dosing were also compared between groups.
Results:
More patients with left MTS had atypical language lateralization (3/5 with right-sided language in the MTS group, compared to 0/5 in the TE group). Patients with MTS had significantly worse scores on the Verbal Comprehension Index (VCI) subscore of the Wechsler Adult Intelligence Scale (WAIS) (p = 0.026). General IQ was also worse in patients with MTS (p = 0.028). There was a trend towards worse executive function in patients with MTS as measured on Trails B (p = 0.096). Other measures related to language and verbal memory did not differ significantly between the groups, nor did other relevant clinical variables, except epilepsy duration, which was significantly longer in patients with MTS (p = 0.0001).
Conclusion:
This pilot study demonstrates a higher rate of atypical language lateralization in patients with left MTS, as well as higher baseline global IQ and VCI scores in patients with left TE compared to patients with MTS. Future work with a larger sample size will focus on establishing a unique neuropsychological profile related to epilepsy due to TE.
Funding:
:n/a
Behavior/Neuropsychology/Language