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ner,
C Helmstaedter,
C E Elger
Klinik für Epileptologie, D-53125 Bonn, Germany
Correspondence to: Dr U Gleiner, Klinik
für Epileptologie, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany.
Telephone 0049 228 287 4436; fax 0049 228 287 6294; email
psych{at}mailer.meb.uni-bonn.de
Received 14
November 1997 and in revised form 30 April 1998;
Accepted 29 May 1998
OBJECTIVES
Existing speculations regarding
the cognitive functions of the right hippocampus suggest a special
involvement in non-verbal memory functions. However, all supporting
evidence in epileptic patients came from postoperative studies that did
not consider the preoperative functioning level. The present study
investigates in patients with right temporal lobe epilepsy (RTLE), both
preoperatively and postoperatively, the role of the right
hippocampus for visual memory, visuoconstruction, and spatial visualisation.
METHODSTwo groups of patients with RTLE with and
without right hippocampal damage (HC+/n=15 v
HC
/n=13) were set up retrospectively thereby taking into
account the surgical treatment (selective amygdalohippocampectomy
v temporal resections sparing the hippocampus), the
postoperative pathological findings (hippocampal sclerosis in the
HC+ group) and the seizure outcome (all seizure free). The
two groups were compared with regard to their neuropsychological
performance preoperatively and 3 months after temporal lobe surgery.
RESULTSThe preoperative results indicated
impaired visual memory performance only for the HC+
patients, whereas the HC patients exhibited no
deficiencies in any of the assessed functions. Postoperatively,
both groups exhibited partially improved performances. The type of
surgical treatment had no different effects on the postoperative
performance changes.
CONCLUSIONSThe results suggest that hippocampal
damage is the major cause of non-verbal memory deficiencies in
preoperative patients with right temporal lobe epilepsy. Hence the
results support and extend findings from previous postoperative
studies. Right hippocampal resections did not increase the preoperative
visual memory deficiencies, thus supporting the view that right
temporal lobe resection in general bears only small risks for cognitve deteriorations.
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