A case study of long-term cognitive and social functioning following a right temporal lobectomy in infancy

Abstract

We present the rare case of an adult patient, FS, who had a right anterior temporal lobe resection during infancy to treat intractable epilepsy, and underwent a cognitive evaluation 19 years later. Given the paucity of literature on long-term outcomes for infants who receive neurosurgery for epilepsy, this case provides valuable information for both clinicians and patients. What little literature exists on infant and child surgical outcomes for epilepsy suggests a variable course, with several areas of possible cognitive and social difficulty. FS's assessment at the age of 21 revealed only mild difficulties with memory, sequencing, and visual imagery, and spared intellectual functioning, working memory, problem-solving and social cognition, along with a high level of socioeconomic functioning. Thus, the case of FS suggests that neurosurgery during infancy is not necessarily associated with large-scale cognitive impairment, and furthermore, that high levels of functioning both educationally and vocationally are possible after surgical treatment of epilepsy in infancy.

Keywords:

• Epilepsy
• Infancy
• Temporal lobe
• Frontal lobe
• Cognition

We would like to thank FS for her generosity with her time, without which this research would not have been possible, and to Dr Mitesh Gandhi for composing and providing the radiology report. This manuscript benefited from the comments of two anonymous reviewers. This research was supported by a University of Queensland Research Development Grant, a University of Queensland International Living Allowance Scholarship, and an Endeavour International Postgraduate Research Scholarship, from the Commonwealth Government of Australia, all awarded to CAH. RAM was supported by a Canadian Social Sciences and Humanities Research Council postdoctoral fellowship during preparation of this manuscript.