Corroboration of Neuropsychological Functioning & MRI

Findings in a Case of Temporal Lobe Epilepsy

Krishna Kumari K1, Jamuna Rajeswaran1, Divya Sadana1, Sanjib Sinha2, P Satishchandra2, Arivazhagan A3,
Malla Bhaskara Rao , Rose Dawn Bharath4
Neuropsychology Unit, Dept of Clinical Psychology, NIMHANS, Bangalore, India 1
Department of Neurology, NIMHANS, Bangalore, India 2
Department of Neurosurgery, NIMHANS , Bangalore , India 3
Department of Neuro Imaging &Interventional Radiology 4

Introduction:
Temporal lobe epilepsy refers to a condition characterized by recurrent, unprovoked seizures originating
from the medial or lateral temporal lobe. The definitive treatment for medically intractable tempral lobe
epilepsy is temporal lobotomy. Presurgical Neuropsychological evaluation has been providing valuable
information in surgical planning of epilepsy. Neuropsychological evaluation helps in diagnosis and in
prediction in individuals being considered for epilepsy surgery.
The neuropsychological evaluation of a person with epilepsy can help us to understand how seizures
influence the brain from a functional point of view as well as localizing the affected brain areas. While the
other tests (EEG and imaging) can help understand the underlying neurological cause and pinpoint the
origin of the seizures, they do not provide information about how seizures affect a persons different
cognitive functions like attention, memory, motor speed, etc. Thus, Neuropsychological testing can provide
additional valuable information which is not provided by imaging tests like MRI. This information can
assist the treatment team in managing the seizures better.
Although, MRI is the most commonly used technique for localizing the affected brain area, it has its own
limitations.MRI being very expensive, cant be made an easily available screening tool .Also the
combination of being put in an enclosed space and the loud noise that are made by the magnets can make
some people feel discomfort, claustrophobic while they are having a MRI scan. Exposure to MRI procedure
can exacerbate certain medical conditions like kidney disease. Using neuropsychological assessment as a
screening tool helps to overcome several drawbacks of MRI.

 AIM: The present study aimed at exploring the relationship

between MRI abnormalities of the brain and
neuropsychological functioning in patient with temporal lobe
epilepsy.

Methodology
Design:A single case study design was adopted
Case Details
Mrs., 32 years old, married, educated, female from M.S.E.S,
Chikmagalore was getting seizure episodes since from the age
of 9 years. She was diagnosed with temporal lobe epilepsy.
Despite taking antiepileptic drugs, she was getting the seizure
episodes frequently. So epilepsy surgery was advised by the
treatment team. She was referred for presurgical evaluation.