The major goal of the proposed research is to provide much needed information as to the long-term behavior effects of temporal-lobe surgery. Temporal lobe surgery is the most frequently performed epilepsy surgery procedure. The clinical results of such surgery have been impressive. However, reports of the behavioral sequelae of surgery are limited, with most studies performed within the first year after surgery. While improvement in emotional and social domains have been reported in the short-term follow-up in the successfully-treated patients, the behavioral sequelae is not always positive. No long-term longitudinal studies of the behavioral effects of temporal lobe surgery are available. The proposed research meets the need for a systematic investigation of the long-term impact of temporal lobe surgery on medical, social and emotional functioning. Studies are based on the longitudinal follow-up of persons who had intractable epilepsy and who underwent a standardized clinical and psychological evaluation in a large university surgical diagnostic center. Three groups of patients are followed: Patients who underwent a standardized temporal lobe resection, patients who underwent an extra- temporal lobe resection and a comparison group of patients who underwent the same pre-surgical evaluation but did not qualify for/or refused surgery. The proposed studies will determine the extent to which the changes seen one year and 5 years after temporal lobe surgery are similar to those seen greater than 9 years post surgery. The interrelationship of emotional, cognitive, and social changes and selected clinical measures will be determined. Finally, as these patients approach ages when normal aging process begin, potential late changes in behavior will be identified. These changes will be related to the impact of seizures and other related treatment effects. These findings will be invaluable to clinicians and general health-care providers involved in clinical decisions on the surgical treatment of epilepsy. Such information will also be important for neurobehavioral scientists interested in following the temporal sequelae of brain lesions with respect to increasing deficits and tot potential recovery mechanisms and neuronal plasticity. Finally, the proposed work will provide prognostic indices for those involved in providing patient rehabilitation services.
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