The impact of left temporal lobe seizure disorder on learning disorders: a case study

This case study describes the relationship between left temporal lobe epilepsy (TLE) and learning disabilities in a 26-year-old male college student. The client developed seizures following an episode of mycoplasma encephalitis at the age of 7. The client underwent a left temporal lobectomy involving resection of the left mesial temporal lobe, amygdala, hippocampus, and part of the brain stem 6 years prior to the current evaluation, in an attempt to address the frequency of the seizures. The surgery was extensive, including neocortical resection extending posterior to the vein of Labbe along the inferior temporal gyrus. The lobectomy reportedly successfully eliminated the seizures and the need for anti-seizure medications, but no neurological or neuropsychological follow-up occurred until 2009 when he was referred by his academic program for an evaluation of learning disabilities. Results of the neuropsychological evaluation indicated significant expressive language functioning deficits, with generally better-preserved receptive language. However, compared to a pre-surgical neuropsychological evaluation there was evidence for subtle to mild improvement in several aspects of cognitive functioning, likely due to seizure elimination and discontinuation of the anti-seizure medication. Nonetheless, his deficits resulted in significant functional impact on his academic abilities, thus implications for academic intervention were discussed.