Abstracts

Rationale: Patients with Temporal Lobe Epilepsy caused by Hippocampal Sclerosis (TLE-HS) have a well-known impairment on episodic memory. However, these abilities have rarely been evaluated in an ecological scenario. The neuropsychological evaluation of memory by traditional tests in an artificial setting raises questions about their applicability to daily routine. Therefore, the results on these tests frequently have little relation to memory complaints (Dubreuil et al., 2007). The aim of the present study is to measure everyday and prospective memory of patients with TLE-HS and to compare their performance to age and gender-matched healthy controls.Methods: We evaluated 30 patients with TLE-HS (mean age 37.83 [SD±13.60]; 21 [70%] female) and their cognitive performance was compared to 27 healthy controls (mean age 31.00 [±9.16]; 17 [62.96%) female), without epilepsy and psychiatric disorders. Patients were assessed using the Rivermead Behavioral Memory Test (RBMT). The impact of epilepsy clinical variable such as age of onset, epilepsy duration, AEDs, history of status epilepticus and febrile seizures, and presence of generalized seizures. Statistical analyses was performed using one-way ANCOVA with age and IQ as confounding factors.Results: Patients showed worse performance than controls on the overall score of RBMT (p<0.001). Patients had more difficult to recall names of unfamiliar people (p=0.039), the place where personal items were stored (p=0.031), to give a message after a short period of time (p=0.025), to remember previous objects presented (p=0.025), a story full of details (p=0.009), a previous presented short route (p=0.015), and had a greater impairment in time and space orientation (p=0.001). Use of polytherapy and lack of seizure control impacted significantly RBMT performance.Conclusions: Patients with TLE-HS demonstrated deficits in everyday memory functions, showing significant impairment in daily activities that would not be evaluated in a standard neuropsychological battery designed to assess episodic memory functions. Seizure frequency and polytherapy impact significantly everyday memory. Impairment in recalling names, routes, stories, messages and a space/time disorientation can adversely impact social adaptation and should receive greater attention in a neuropsychological evaluation of patients with memory complaints.