Neuropsychological Symptoms Following Complex Partial Seizures

An Attempt of their Classification as a Function of the Recovery Time of Semantic Memory and Episodic Memory

Abstract

One hundred and eight postictal confusional states following complex partial seizures in twenty two temporal lobe epileptics were examined. The test battery consisted of three questions concerning orientation, seven tasks of confrontation naming, four tasks of kana reading, and three tasks of kanji reading. These questions were given repeatedly until the target words were produced in all the questions. All the verbal reactions were tape-recorded and transcribed into written material. The recorded paraphasias were categorized according to the modified taxonomy of Lecours. The time required for the full recovery of orientation was used as a scale of the episodic memory impairment and that of naming and reading as a scale of the semantic memory impairment. As a result, four different types of postictal neuropsychological states were differentiated. In the first type, the test battery failed to show almost any disturbance of episodic as well as semantic memory. The episodic memory recovered much more slowly than the semantic memory in the second type. In the third type, the semantic memory recovered as slowly as the episodic memory. Patients with a unique constellation of paraphasias characterized by formal nominal paraphasias and neologisms closely related to formal nominal paraphasias constituted the fourth type. The former two types were related to the right temporal dysfunction and the latter two types to the left temporal dysfunction.