Abstracts

The Wechsler Memory Scale-III (WMS-3) touted a number of technical and normative improvements over the older, Revised version (WMS-R), of the scale, but its performance with temporal lobe seizure patients is still unknown. This is unfortunate, as the older Revised version of this test has been shown to have some utility in this regard. The purpose of this study was to evaluate the lateralizing value of the WMS-3 Logical Memory (LM) and Visual Reproduction (VR) subtests, versus the older Revised version, in temporal lobe seizure patients., Eight temporal lobe patients who had undergone preoperative studies and received the WMS-3, and 8 consecutive patients who had undergone preoperative studies with the WMS-R and matched as closely as possible on age, sex, and length of seizure disorder, were used in this study. The WMS was administered and scored in a manner consistent with information provided in the respective manuals. There was video EEG, MRI, and FDG PET available for diagnosing the side of seizure onset. WMS was used to determine predicted side of onset by looking at the difference between the two subtests at the delay (LM-VR), for standard scores in the case of WMS-3, and the percentile ranks for the WMS-R. Classification was Left if the value was positive, and Right if the value was negative. Sensitivity and specificity were calculated relative to localization by EEG, MRI, and PET results., The sensitivity of the WMS-3 for predicting left temporal dysfunction was a poor .60 (the specificity was 1.00). The sensitivity for the WMS-R was 1.00, with a specificity of .667. For predicting right temporal lobe dysfunction from WMS-3, the sensitivity was 1.0, but the specificity was .333, which is a poor showing indeed. For the WMS-R, the sensitivity was .667, and the specificity was 1.0., The WMS-3 Logical Memory and Visual Reproduction subscales do not predict side of lesion in temporal lobe epilepsy with any greater precision than do the corresponding scales in the WMS-R; the opposite may, in fact, be true. The neuropsychologist must decide whether the added time to administer the scales in the WMS-3, which are substantially more involved than the simpler WMS-R scales, is worth the additional effort, or whether time would be better spent on administering and scoring other measures. Newer versions of these, or alternate, tests should be explored in an effort to find more sensitive and specific tests of temporal lobe dysfunction.,