REPORTS BY PATIENTS AND THEIR FAMILIES OF MEMORY CHANGE AFTER LEFT ANTERIOR TEMPORAL LOBECTOMY - RELATIONSHIP TO DEGREE OF HIPPOCAMPAL SCLEROSIS

MEMORY DECLINE REPRESENTS the primary neuropsychological morbidity of anterior temporal lobectomy. Recent investigations using laboratory te sts of memory have reported an association between the neuropathologic al status of the resected left mesial temporal region and memory outco me, with adverse memory outcome associated with a lack of significant left hippocampal pathology. The purpose of this investigation was to e xamine the relationship between the reports by the patients and their families of observed postoperative changes in day-to-day memory functi on and the degree of hippocampal sclerosis in resected left mesial tem poral lobes. Twenty patients and a close family member (parent or spou se) of each of the patients completed standardized questionnaires asse ssing pre- to postoperative changes in verbal and spatial memory; thes e were related to the neuropathological findings. The results indicate d that patients without left hippocampal sclerosis reported significan tly worse memory outcome than those with hippocampal sclerosis. The ra tings provided by the relatives of the patients yielded a comparable e ffect, and objective memory tests supported the reports by the patient s and their families. The neuropsychological findings associated with left hippocampal pathology are of clinical significance and should be considered in surgical evaluation and in the counseling process.