Open Access
CC BY-NC-ND 4.0 · International Journal of Epilepsy 2023; 09(01/02): A1-A40
DOI: 10.1055/s-0044-1791465
E-Poster Abstracts

Impact of Seizure Freedom and Medications on Long-Term Cognitive Trajectories Post-Anterior Temporal Lobectomy (ATL)

Authors

  • Neha Pai

    1   Department of Neurology, GSMC and KEM Hospital, Mumbai, Maharashtra, India

  • Mayuri Kalika

    1   Department of Neurology, GSMC and KEM Hospital, Mumbai, Maharashtra, India

  • Sharvi Bhanushal

    1   Department of Neurology, GSMC and KEM Hospital, Mumbai, Maharashtra, India
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    Keywords

    cognitive outcomes - anterior temporal lobectomy - long-term outcomes - epilepsy surgery - processing speed - attention - memory - seizure freedom - antiseizure medications

    Cognitive issues are ubiquitous with epilepsy and ongoing seizures, and anti-epileptic medications (ASMs) are known to impact processing speed and attention. Most studies have focused on memory outcomes 1-year post-ATL surgery. There is sparse literature to understand long-term outcomes in other cognitive domains.

    Aim: Our study assesses postsurgery cognitive shifts in processing speed, attention, memory, and language.

    Method: Retrospective data analysis of patients who underwent ATL and fulfilled inclusion criteria of (1) test data for three time points: preoperative (T0), 1-year postoperative (T1), and long-term 5-year postoperative (T2); (2) seizure freedom, Engel's classification I and discontinuation of all antiseizure medications (ASMs) at the long term, (3) no psychiatric comorbidity, (4) normal intelligence. A repeated measures ANOVA analysis was performed.

    Results: The data analysis of 43 patients who fulfilled the inclusion criteria revealed significant group main effects (p < 0.05) for attention and processing speed. Post hoc analysis showed a significant improvement in processing speed between T0–T1 and T0–T2, while a significant improvement in focused attention was observed only between T0–T2 when, with seizure freedom, there was the discontinuation of ASMs.

    Conclusions: There is differential improvement in the cognitive domains in the short and long term. Processing speed improves with seizure freedom at one-year, but improvements in attention occur only on stoppage of ASMs in the long term. Improvements in attention may indirectly benefit memory. The long-term benefits of seizure freedom and discontinuation of ASMs are important findings for counseling and planning the rehabilitation of patients who undergo ATL.


     

    Die Autoren geben an, dass kein Interessenkonflikt besteht.

    Publikationsverlauf

    Artikel online veröffentlicht:
    12. September 2024

    © 2023. Indian Epilepsy Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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