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The patient's experience of memory change after elective temporal lobe resection.

Subjective memory has emerged as a relevant indicator of outcome following temporal lobe resection (TLR) for the treatment of intractable temporal lobe epilepsy. Study 1 asks whether patients undergoing TLR experience subjectively-perceived memory changes one year following surgery. The Memory Observation Questionnaire provided data for both individual and group level analyses. Reliable change index results indicated that most patients and informants (i.e., a family or close friend) reported no change or improvement after the surgery, and 7.8% reported deterioration. Aggregate scores showed that mean ratings of subjective memory ratings significantly improved or did not change following surgery. Study 2 is a meta-analysis of six different publications on subjective memory comprising 465 TLR patients and 171 informants (i.e., 25 effect sizes). The weighted mean effect size of 0.27 was small, yet significantly larger than zero in the direction of perceived improvement. These findings suggest that most TLR surgical epilepsy patients do not notice post-operative changes in their memory function. Accordingly, we propose that a comprehensive discussion of surgical risks and benefits incorporates both patient impressions, along with objective memory outcomes.