Neuropsychological Functioning in Bilateral versus Unilateral Temporal Lobe Epilepsy

Author:

Baggio Martina1,Danieli Alberto1,Crescentini Cristiano2ORCID,Duma Gian Marco1,Da Rold Martina3,Baldini Sara4,Pascoli Eric5,Antoniazzi Lisa1,Vestri Alec1ORCID,Fabbro Franco26,Bonanni Paolo1

Affiliation:

1. Epilepsy and Clinical Neurophysiology Unit, Scientific Institute, IRCCS E. Medea, Via Costa Alta 37, 31015 Conegliano, Italy

2. Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100 Udine, Italy

3. Aulss 2 Marca Trevigiana, Piazzale Dell’Ospedale, 1, 31100 Treviso, Italy

4. Clinical Unit of Neurology, Department of Medical Sciences, University Hospital and Health Services of Trieste, University of Trieste, 34129 Trieste, Italy

5. Department of Medicine—DAME, University of Udine, 33100 Udine, Italy

6. PERCRO Perceptual Robotics Laboratory, Scuola Superiore Sant’Anna, 56010 Pisa, Italy

Abstract

Although relatively specific anatomo-electro-clinical features of temporal lobe epilepsy (TLE) with bilateral ictal involvement (bitemporal epilepsy—BTLE) have been described, differentiating between BTLE and unilateral TLE (UTLE) remains challenging. Surgery is often the treatment of choice for drug-resistant UTLE, whereas its use is more controversial in BTLE. It is currently unclear whether neuropsychological assessment can contribute to the differential diagnosis. We retrospectively reviewed the neuropsychological evaluation of 46 consecutive patients with refractory TLE. Eighteen patients were diagnosed with BTLE on the basis of ictal electro-clinical data, in particular a video EEG recording of at least one seizure simultaneously involving the two temporal lobes without the possibility of lateralizing its onset or at least two different seizures independently arising from the two temporal lobes. Twenty-eight patients were classified as UTLE. Presurgery evaluation data were used in this study. Compared with UTLE, BTLE was associated with a lower intelligence quotient (IQ) and more severe impairment in long-term memory, the latter remaining significant even after controlling for IQ. No significant differences were found between right and left UTLE. In conclusion, BTLE and UTLE are associated with relatively distinct neuropsychological profiles, further supporting their classification as different disorders within the TLE spectrum.

Funder

The Italian Health Ministry

Publisher

MDPI AG

Subject

General Neuroscience

Reference32 articles.

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