Hostname: page-component-cd4964975-ppllx Total loading time: 0 Render date: 2023-03-30T12:50:55.999Z Has data issue: true Feature Flags: { "useRatesEcommerce": false } hasContentIssue true

Temporal Lobectomy with Delayed Amnesia Following a New Lesion on the Other Side

Published online by Cambridge University Press:  23 September 2014

Andrea Salmon
Departments of Clinical Neurological Sciences, Western University, London, Ontario, Canada
Brent Hayman-Abello
Psychology, Western University, London, Ontario, Canada
Barbara Connolly
Departments of Clinical Neurological Sciences, Western University, London, Ontario, Canada
Richard S. McLachlan*
Departments of Clinical Neurological Sciences, Western University, London, Ontario, Canada
Department of Clinical Neurological Sciences, London Health Sciences Centre, 339 Windermere Rd, London, Ontario, Canada. Email:
Rights & Permissions[Opens in a new window]


HTML view is not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

To describe a delayed severe complication of temporal lobectomy for intractable epilepsy.


A case of amnesia occurring 24 years after surgery is described and five similar cases from the literature reviewed.


Mean age at surgery (5 right) was 40 years (19-62 years), 3 female. Four of five tested had impaired visual and verbal memory preoperatively but not sufficient to contraindicate surgery. Pathology was mesial temporal sclerosis in 3, 1 cavernoma, 1 dysembryoplastic neuroepithelial tumor (DNET) and 1 normal. Postoperatively, four were seizure free 3-12 years off medication and two continued with seizures. There was no unexpected postoperative memory change until incapacitating anterograde amnesia developed 1-24 years after surgery. In five patients, including ours, this followed definite or possible status epilepticus with new mesial temporal sclerosis on the opposite side in the four that were investigated by MRI. One patient developed a glioblastoma in the opposite temporal lobe.


Continuing or late recurrence of seizures from the remaining temporal lobe after temporal lobectomy can result in incapacitating amnesia if status epilepticus occurs. Other new lesions on the opposite side to surgery can have the same effect.

Original Article
Copyright © The Canadian Journal of Neurological 2014


1.Baxendale, S.Amnesia in temporal lobectomy patients: historical perspective and review. Seizure. 1998;7:1524.CrossRefGoogle ScholarPubMed
2.Scoville, WB.Amnesia after bilateral mesial temporal lobe excision: introduction to case HM. Neuropsychologia. 1968;6:2113.CrossRefGoogle Scholar
3.Milner, B, Corkin, S, Teuber, HL.Further analysis of the hippocampal amnesic syndrome; 14 year follow-up study of HM. Neuropsychologia. 1968;6:21534.CrossRefGoogle Scholar
4.Kapur, N, Prevett, M.Unexpected amnesia: are there lessons to be learned from cases of amnesia following unilateral temporal lobe surgery? Brain. 2003;126:257385.CrossRefGoogle ScholarPubMed
5.Walker, AE.Recent memory impairment in unilateral temporal lesions. AMA Arch Neurol Psychiatry. 1957;78:54352.CrossRefGoogle ScholarPubMed
6.Oxbury, S, Oxbury, J, Renowden, S, Squier, W, Carpenter, K.Severe amnesia: an unusual late complication after temporal lobectomy. Neuropsychologia. 1997;35:97588.CrossRefGoogle Scholar
7.Dietl, T, Urbach, H, Helmstaedter, C, et al. Persistent severe amnesia due to seizure recurrence after unilateral temporal lobectomy. Epilepsy Behav. 2004;5:394400.CrossRefGoogle ScholarPubMed
8.Di Gennaro, G, Grammaldo, LG, Quarato, PP, et al. Severe amnesia following bilateral medial temporal lobe damage occurring on two distinct occasions. Neurol Sci. 2006;27:12933.CrossRefGoogle ScholarPubMed
9.Kubu, CS, Girvin, JP, McLachlan, RS, Pavol, M, Harnadek, MCS.Does the intracarotid amobarbital procedure predict global amnesia after temporal lobectomy? Epilepsia. 2000;41:13219.CrossRefGoogle ScholarPubMed
10.Martin, R, Sawrie, S, Gilliam, F, et al. Determining reliable cognitive change after epilepsy surgery: development of reliable change indices and standardized regression-based change norms for the WMS-III and WAIS-III. Epilepsia. 2002;43:15518.CrossRefGoogle ScholarPubMed
11.Sawrie, SM, Chelune, GJ, Naugle, RI, Luders, HO.Empirical methods for assessing meaningful neuropsychological change following epilepsy surgery. J Int Neuropsychol Soc. 1996;2:55664.CrossRefGoogle ScholarPubMed
12.Kopelman, MD, Wilson, BA, Baddeley, AD.The Autobiographical Memory Interview. Thames Valley Test Company. 1990. Suffolk, England.Google Scholar
13.Engel, J Jr, Wiebe, S, French, J, et al. Practice parameter: temporal lobe and localized neocortical resections for epilepsy: report of the Quality Standards Subcommittee of the American Academy of Neurology, in association with the American Epilepsy Society and the American Association of Neurological Surgeons. Neurology. 2003;60:53847.CrossRefGoogle ScholarPubMed
14.Schmidt, D, Baumgartner, C, Loscher, W.Seizure recurrence after planned discontinuation of antiepileptic drugs in seizure-free patients after epilepsy surgery: a review of current clinical experience. Epilepsia. 2004;45:17986.CrossRefGoogle ScholarPubMed
15.McIntosh, AM, Kalnins, RM, Mitchell, LA, Fabinyi, GC, Briellmann, RS, Berkovic, SF.Temporal lobectomy: long-term seizure outcome, late recurrence and risks for seizure recurrence. Brain. 2004;127:201830.CrossRefGoogle ScholarPubMed
16.Harroud, A, Bouthillier, A, Weil, AG, Nguyen, DK. Temporal lobe epilepsy surgery failures: a review. Epilepsy Res Treat. 2012;2012:201651.CrossRefGoogle Scholar
17.Sadler, RM.The syndrome of mesial temporal lobe epilepsy with hippocampal sclerosis: clinical features and differential diagnosis. Adv Neurol. 2006;97:2737.Google ScholarPubMed
18.Spiers, HJ, Maguire, EA, Burgess, N.Hippocampal amnesia. Neurocase. 2001;7:35782.CrossRefGoogle ScholarPubMed
19.Rushing, EJ, Barnard, JJ, Bigio, EH, Eagan, KP, White, CL III. Frequency of unilateral and bilateral mesial temporal sclerosis in primary and secondary epilepsy: a forensic autopsy study. Am J Forensic Med Pathol. 1997;18:33541.CrossRefGoogle ScholarPubMed
20.Ramos, E, Benbadis, S, Vale, FL.Failure of temporal lobe resection for epilepsy in patients with mesial temporal sclerosis: results and treatment options. J Neurosurg. 2009;110:112734.CrossRefGoogle ScholarPubMed
21.Tsuchida, TN, Barkovich, AJ, Bollen, AW, Hart, AP, Ferriero, DM.Childhood status epilepticus and excitotoxic neuronal injury. Pediatr Neurol. 2007;36:2537.CrossRefGoogle ScholarPubMed