NONVERBAL SELECTIVE REMINDING TEST - EFFICACY IN THE ASSESSMENT OF ADULTS WITH TEMPORAL-LOBE EPILEPSY

Although the relationship of verbal memory tests to left temporal lobe epilepsy (LTLE) has reportedly been well established, research on the relationship of nonverbal memory to right TLE (RTLE) has yielded mixe d findings, thus bringing into question the clinical utility of nonver bal memory assessment. In the present study, we used a selective remin ding procedure for nonverbal spatial material to control for procedura l factors, such as verbal mediation, which may in part be the basis fo r these mixed findings. A sample of 39 LTLE patients and 33 RTLE patie nts were given both a test of verbal selective reminding (VSR) and a t est of nonverbal selective reminding (NVSR) as part of a presurgical e valuation. Diagnosis of RTLE and LTLE was rendered after an extensive presurgical evaluation including magnetic resonance imaging, video-ele ctroencephalography, the intracarotid sodium amytal procedure, and int racranial electrodes when necessary. Results obtained from the NVSR al lowed better classification of patients than did VSR, yielding 40% abo ve chance classification. More important, given impaired performance, the probability that a patient had RTLE was 0.70. VSR performance did not allow for classification significantly above chance levels. Althou gh combining the results from the VSR and NVSR resulted in the best cl assification, the gain was minimal (72% vs. 70% for NVSR alone), parti cularly because 26 patients could not be classified. Our results suppo rt previous findings of a relationship between nonverbal memory perfor mance and RTLE epilepsy but bring into question the unequivocal accept ance of an exclusive relationship of verbal memory to LTLE.