Multivariate Neuropsychological Prediction of Seizure Lateralization in Temporal Epilepsy Surgical Cases

Abstract

Summary:Purpose: Neuropsychological assessment can be of assistance in determining seizure lateralization in cases where EEG and MRI findings do not provide clear lateralizing data. While several studies have examined the lateralizing value of individual neuropsychological measures, clinicians are still in need of a statistically sound method that permits the incorporation of multiple neuropsychological variables to predict seizure lateralization in the individual patient.Method: The present study investigated the lateralizing value of several commonly used neuropsychological measures in a large sample of patients (n = 217) who eventually underwent surgical resection to treat their epilepsy. Side of surgery was used to operationally define seizure lateralization. A comparison of the relative utility of a multivariate versus univariate approach to predict seizure lateralization was conducted in temporal epilepsy cases.Results: The results provide evidence for the incremental validity of neuropsychological measures, other than memory and IQ tests, in the prediction of seizure lateralization in patients with medically intractable epilepsy. These data indicate that a multivariate approach increases the accuracy of prediction of seizure lateralization for temporal lobe epilepsy cases.Conclusion: This study supports the use of a multivariate approach using neuropsychological measures to predict seizure lateralization in temporal epilepsy surgical candidates. Regression formulas are provided to enhance the clinical utility of these findings.

Clinical utility of the Wechsler Memory Scale—Fourth Edition (WMS-IV) in predicting laterality of temporal lobe epilepsy among surgical candidates

“…There is limited evidence for the Rey-Osterrieth Complex Figure Test [3,7]. Confrontation-naming measures, particularly the Boston Naming Test (BNT), have also been shown to predict seizure laterality and ultimate side of surgical resection [8][9][10][11]. Loring …”

The Role of Neuropsychological Assessment in the Functional Outcomes of Children with ADHD

“…For example, the epilepsy literature indicates that neuropsychological assessments are useful in localizing behavioral dysfunction, predicting seizure lateralization, providing a baseline from which to measure cognitive decline due to the epilepsy itself or the treatments for the condition (e.g., medication), and predicting cognitive outcomes following surgery (Buckley et al 2010;Jones-Gotman et al 2010;Keary et al 2007). Similarly, within the realm of neuro-oncology, neuropsychological assessments have been shown to be useful in disentangling cognitive and behavioral effects of brain tumors themselves from the effects of pharmacological and surgical treatments for the tumors in order to assist with medical decision-making (Iuvone et al 2011).…”

Determinates Clínicos en La Memoria Autobiográfica De Pacientes Con Epilepsia Del Lóbulo Temporal

“…El paciente con epilepsia del lóbulo temporal (ELT) presenta generalmente una enfermedad de difícil manejo (Cendes, 2004;Mohanraj & Brodie, 2006;Wiebe, 2000), y cursa con alteraciones en el funcionamiento cognitivo, específicamente trastornos de la memoria (Keary, Frazier, Busch, Kubu, & Iampietro, 2007;Sheth, 2002). La memoria episódica se relaciona con el recuerdo de las situaciones en general, tanto en las que la persona ha tenido un papel únicamente expectante, como aquellos sucesos en los que participa de manera activa y se involucra afectivamente (Carrillo-Mora, 2010).…”