Does the intracarotid amobarbital procedure predict global amnesia after temporal lobectomy?

被引:30
作者
Kubu, CS
Girvin, JP
McLachlan, RS
Pavol, M
Harnadek, MCS
机构
[1] London Hlth Sci Ctr, Psychol Serv, London, ON N6A 5A5, Canada
[2] Univ Western Ontario, Dept Clin Neurol Sci, London, ON, Canada
关键词
wada; intracarotid amobarbital procedure; memory;
D O I
10.1111/j.1528-1157.2000.tb04612.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Purpose: The intracarotid amobarbital procedure (IAP) is widely used to help predict who might be at risk for postoperative amnesia after unilateral temporal lobectomy for intractable seizures. We describe the memory outcome in 10 patients who underwent standard temporal lobectomy, including mesial temporal structures, despite failing the memory portion of the IAP after injections both ipsilateral and contralateral to the resected seizure focus. Methods: Data for seven of the study subjects were obtained through a retrospective review of patients assessed on a surgical epilepsy unit during a 15-year period who failed the Montreal Neurological Institute IAP memory protocol after both ipsilateral and contralateral injections and subsequently underwent unilateral temporal lobectomy. More recently, we have studied temporal lobectomy patients who failed the Medical College of Georgia memory protocol after both ipsilateral and contralateral injections (n = 3). Preoperative and postoperative memory test scores were compared, and data regarding sei zure outcome and self-perception of postoperative memory were collected. Results: At follow-up, none of the patients presented with a pattern indicative of a global amnesia, and 80% demonstrated >90% improvement in their seizure disorder or were seizure-free. Conclusions: These findings indicate that bilateral memory failure on the LAP does not preclude the removal of an epileptogenic temporal lobe or a successful surgical outcome. In addition, the findings raise questions regarding the validity of the IAP and the possibility that memory may be reorganized in patients with a long history of temporal lobe epilepsy.
引用
收藏
页码:1321 / 1329
页数:9
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