Verbal memory after temporal lobe epilepsy surgery in children: Do only mesial structures matter?

Area of Science:

• Pediatric Neurology
• Epilepsy Surgery
• Cognitive Neuroscience

Background:

• Verbal memory outcomes after pediatric temporal lobectomy are inconsistently reported.
• Limited research compares lateral versus mesial temporal lobe resection effects on verbal memory.
• Understanding factors influencing post-surgical verbal memory is crucial for surgical planning.

Purpose of the Study:

• To compare verbal memory changes after temporal lobe resection sparing or including mesial structures in children.
• To identify predictors of verbal memory decline following pediatric temporal lobe epilepsy surgery.
• To investigate the impact of surgical approach on verbal memory in pediatric epilepsy.

Main Methods:

• Retrospective analysis of verbal memory using a list learning task approximately 1 year post-surgery.
• Comparison of children with mesial structure sparing (n=23) versus mesial structure resection (n=40).
• Inclusion of left and right temporal lobe resections, with a focus on left-sided language representation.

Main Results:

• Only children with left lateral and mesial temporal lobe resection showed verbal memory decline.
• Left language representation with mesial structure resection predicted verbal memory decline.
• Intact preoperative verbal memory was associated with greater postsurgical decline compared to below-average preoperative memory.

Conclusions:

• Left mesial temporal lobe epilepsy surgery poses specific risks for verbal memory decline in children.
• Children with left language dominance and intact preoperative memory undergoing left temporal lobe surgery including mesial structures are most vulnerable.
• Surgical strategy and baseline memory function are key considerations for preserving verbal memory post-epilepsy surgery.