Intracartotid amobarbital procedure memory performance and age at first risk for seizures distinguish between lateral neocortical and mesial temporal lobe epilepsy

Marla J. Hamberger, Thaddeus S. Walczak, Robert R. Goodman

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Purpose: To determine whether intracarotid amobarbital procedure (IAP) memory-performance asymmetries and early risk factors for epilepsy distinguish between lateral neocortical temporal lobe epilepsy (LNTLE) and mesiobasal temporal lobe epilepsy (MBTLE). Methods: We studied 10 patients with LNTLE and 22 with MBTLE. All LNTLE patients showed (a) presence of temporal neocortical lesion or lateral seizure onset by intracranial recording, and (b) absence of mesial temporal sclerosis (MTS) by histopathologic analysis. All patients with MBTLE showed (a) video-scalp EEG seizures consistent with mesial TLE, and (b) presence of unilateral MTS by histopathologic analysis. All patients had good surgical outcomes (Engel I or II). Unilateral IAP memory performance was defined as percentage of memory items presented during hemispheric anesthesia that was recognized after recovery. IAP asymmetric scores were the differences in memory performance after right and left injections. Results: Mean memory-asymmetry scores were significantly lower in the LNTLE than in the MBTLE; group. An IAP memory asymmetry of <25% correctly classified seven of 10 patients with LNTLE, and a asymmetry of >25% correctly classified 18 of 22 patients with MBTLE. Age at first risk for epilepsy was significantly younger in those with MBTLE than in those with nonlesional LNTLE. Results suggest that both IAP memory performance and age at first risk can help distinguish between MBTLE and LNTLE.

Original languageEnglish (US)
Pages (from-to)1088-1092
Number of pages5
JournalEpilepsia
Volume37
Issue number11
DOIs
StatePublished - Jan 1 1996

Keywords

  • Amobarbital
  • Epilepsy
  • Risk factor
  • Temporal lobe
  • Wada test

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