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Temporal Lobectomy with Delayed Amnesia Following a New Lesion on the Other Side

Published online by Cambridge University Press:  23 September 2014

Andrea Salmon ,
Brent Hayman-Abello ,
Barbara Connolly  and
Richard S. McLachlan
Andrea Salmon
Affiliation:
Departments of Clinical Neurological Sciences, Western University, London, Ontario, Canada
Brent Hayman-Abello
Affiliation:
Psychology, Western University, London, Ontario, Canada
Barbara Connolly
Affiliation:
Departments of Clinical Neurological Sciences, Western University, London, Ontario, Canada
Richard S. McLachlan*
Affiliation:
Departments of Clinical Neurological Sciences, Western University, London, Ontario, Canada
*
Department of Clinical Neurological Sciences, London Health Sciences Centre, 339 Windermere Rd, London, Ontario, Canada. Email: rsmcl@uwo.ca
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Abstract

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Purpose:

To describe a delayed severe complication of temporal lobectomy for intractable epilepsy.

Method:

A case of amnesia occurring 24 years after surgery is described and five similar cases from the literature reviewed.

Results:

Mean age at surgery (5 right) was 40 years (19-62 years), 3 female. Four of five tested had impaired visual and verbal memory preoperatively but not sufficient to contraindicate surgery. Pathology was mesial temporal sclerosis in 3, 1 cavernoma, 1 dysembryoplastic neuroepithelial tumor (DNET) and 1 normal. Postoperatively, four were seizure free 3-12 years off medication and two continued with seizures. There was no unexpected postoperative memory change until incapacitating anterograde amnesia developed 1-24 years after surgery. In five patients, including ours, this followed definite or possible status epilepticus with new mesial temporal sclerosis on the opposite side in the four that were investigated by MRI. One patient developed a glioblastoma in the opposite temporal lobe.

Conclusion:

Continuing or late recurrence of seizures from the remaining temporal lobe after temporal lobectomy can result in incapacitating amnesia if status epilepticus occurs. Other new lesions on the opposite side to surgery can have the same effect.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 41 , Issue 2 , March 2014 , pp. 220 - 225
Copyright
Copyright © The Canadian Journal of Neurological 2014

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