Abstract
We present an update of the literature concerning long-term neuropsychological outcomes following surgery for refractory temporal lobe epilepsy (TLE). A thorough search was conducted through the PubMed and Medline electronic databases for studies investigating neuropsychological function in adult patients undergoing resective TLE surgery and followed for a mean/median > five years period. Two independent reviewers screened citations for eligibility and assessed relevant studies for the risk of bias. We found eleven studies fulfilling the above requirements. Cognitive function remained stable through long-term follow up despite immediate post-surgery decline; a negative relation between seizure control and memory impairment has emerged and a possible role of more selective surgery procedures is highlighted.
Highlights
Epilepsy surgery is nowadays an evidence-based treatment strategy for patients with drug-resistant epilepsy [1,2]
These findings have been challenged by later data, where cognitive function remained stable at one year following surgery, showing no evidence of accelerated memory decline (Engman et al, 2006; Alpherts et al, 2006; Andersson-Roswall et al, 2010; Baxendale et al, 2012; Salvato et al, 2016; Helmstaedter et al, 2018)
Given that few reports have focused on the long-term neuropsychological consequences of temporal lobe epilepsy (TLE) surgery, we attempted to provide a review of the literature, investigating neuropsychological function of adult patients undergoing resective TLE surgery and followed for a mean/median > five years period
Summary
Epilepsy surgery is nowadays an evidence-based treatment strategy for patients with drug-resistant epilepsy [1,2]. Highlighting the need for more reliable studies reviewing the non-seizure outcomes, neuropsychological data have been evaluated and much has been documented on long-term postoperative cognitive outcomes [8,9] an association with temporal lobe (TL) surgery and progressive memory decline has been suggested [10,11], while, currently, cognitive function is Healthcare 2021, 9, 1156. Healthcare 2021, 9, 1156 Healthcare 2021, 9, 1156 suggested [10,11], while, currently, cognitive function is considered to remain stable one year after surgery [12]. Various factors such as chronological age, seizure recurrence, bcounrdsiedneroefdmtoedreicmaatiionnstaanbdletoynpeeyoefasruarfgteerrysuhragvereyb[e1e2n]. WWee ppeerrffoorrmmeeddaacocommpprerhehenensisvievelitleitreartautruerseeasercahrcohnoPnubPMubeMd ewditwh iathreastrriecsttiroincttioonfutlolfluenllg-ltehnEgtnhglEisnhgalirsthiclaerstipculebslipshuebdlisthilel dNotivllemNboevrem20b2e0r, a2s02w0e,llasaswreevllieaws sr,eovriiegwinsa, loarritgiicnleasl aarntdiclbeosoakncdhabpotoekrsc, haanpdtecrosn, saunldtedcoenxspuelrttesdaebxopuetrotsthaebrosutut doitehse. rWsteuudsieesd. tWhee foulsleodwitnhge fsoelalorcwhintegrmsseainrchvartieorumsscoimn bivnaartiioounss: c“ormefrbainctaotrioyntse:m“proerfaral csteoirzyuretes”m, p“onreaulrosseuizrguererys””,, ““cnoegunriotsivuergoeurtyc”o,m“ceo”g, “nmitievme ooruyt”coamnde”“,l“omnge-mteormry”foalnlodw“-luopn”g.-term follow-up”
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