Epilepsy Surgery – Post-Operative Memory Deficit — SCE Neurology MCQ

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HardEpilepsy & Seizure DisordersEpilepsy Surgery – Post-Operative Memory DeficitSCE Neurology

A 52-year-old man with drug-resistant right temporal lobe epilepsy undergoes anterior temporal lobectomy. Post-operatively he develops a selective deficit in learning new verbal information while his visual memory is preserved. Which structure was most likely resected?

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Correct answer: B — Left hippocampus

Verbal memory (learning new words, stories, word lists) is predominantly a function of the language-dominant (usually left) medial temporal lobe, particularly the hippocampus. If the patient had right temporal lobe epilepsy but left-dominant language, a right-sided resection should not impair verbal memory — unless the surgery was actually on the left. This question tests whether the candidate recognises that a verbal memory deficit localises to the dominant (left) temporal lobe. The scenario implies the surgery was on the dominant side. A: Right hippocampal resection impairs visual/spatial memory. C: Amygdala resection causes emotional processing deficits. D: Frontal lobe resection causes executive dysfunction. E: Parietal lobe is involved in spatial processing.

Reference: NICE NG217 (2025); ILAE Commission on Neurosurgery