Beating the Odds: Intact Neuropsychological Functioning despite TLE

Abstract

Patients with Temporal lobe epilepsy (TLE) frequently display cognitive comorbidity and can have widespread network abnormalities, which might affect a variety of cognitive and intellectual functions. As a result, refractory TLE seems to be associated with slow but ongoing cognitive deterioration. The case is of a 32 year old, right handed male, engineering graduate, diagnosed with TLE- right mesial, 12 years ago. A number of head injuries were caused due to the seizure present, which includes a fall from height of 12 feet in childhood. The neuropsychological tests administered were Gesell’s Drawing Test, Mini Mental State Examination, PGI Memory Scale, Battery of Performance Tests of Intelligence, Verbal Adult Intelligence Scale, Hamilton Rating Scale for Depression, Bender Visual Motor Gestalt Test and Dysfunction Analysis Questionnaire. No impairment found on orientation; average cognitive functioning; above average attention and concentration, verbal working memory, visual and verbal memory; average practical ability, abstract ability, average verbal intellectual ability; superior ability on comprehension and average performance ability. Mild to moderate impairment on perceptuo-motor functioning and an evidence of depression were present. Patient showed high dysfunction in personal, social, vocational and cognitive areas. The study highlights that even despite chronic epilepsy, with a series of head injuries due to the seizures; an individual can still have average neuropsychological abilities. Holistic neuropsychological rehabilitation along with Vocational Retraining would go a long way in the functional independence of the patient. Neuropsychologists have a significant role in the assessment, treatment, and rehabilitation of people with epilepsy.