Disturbances of memory are among the most common complaints in TLE. Epilepsy surgery may be curative but can compromise memory function. Patients undergoing left temporal lobe surgery often have memory deficits before surgery and postoperative worsening of both verbal learning and memory1. Memory function is most impaired in people with bilateral anatomic or functional hippocampal lesions. Operations within the dominant temporal lobe have the strongest association with predicting post-operative memory decline, pre-operative immediate verbal memory the weakest, and delayed worsening that may become noted over the subsequent 2 year course2. Mechanisms for apparent interictal memory dysfunction includes injury to the mesial temporal lobe, impairment from AEDs, and possibly frequent epileptiform discharges that transiently disrupt cognitive processing. Our patient underwent a selective amygdalohippocampectomy after iEEG recorded frequent subclinical seizures. She has been seizure free for > 6 months and is on 2 AEDs. Working memory acquisition and consolidation problems “greatly improved” following dominant temporal lobe surgery.
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