Epilepsy, cognition and temporal lobe resection

Epilepsy surgery is the only option for cure in pharmaco-resistant epilepsy, an effective treatment with positive health economic consequences. 60-70 % become seizure free from temporal lobe surgery. However, epilepsy surgery is not without risk for the patient. Our results will increase safety and refine selection criteria by identifying patient that gain from surgery without suffering functional memory loss. Our methods include: fMRI, 7 Tesla MRI and psychometric tests. Results can directly be implemented as clinical routines in the Lund epilepsy program

We have shown that pre-surgical memory testing, combined with language lateralization by functional MRI, can predict post-surgical memory outcome. We created a risk assessment score for post-surgical memory deficits which had a specificity of 67 % and a sensitivity of 75%. Significant correlations were found between frontal language indices in fMRI and post-surgical verbal memory for left TLE, and between medial temporal lobe language indices and visuospatial memory as well as verbal memory for right TLE. Atypical fMRI pattern in verbal memory assessment were associated to unexpected verbal memory deficit after surgery.