Accelerated forgetting and verbal memory consolidation process in idiopathic nondement Parkinson's disease.

OBJECTIVE: Episodic memory impairment and underlying pathophysiology in Parkinson's Disease (PD) is poorly investigated. Formerly, it was thought to be a secondary effect of impairment in fronto-striatal circuit. However, recent studies hypothesized that there is a dual progression of PD and memory loss is possibly related to posterior cortex rather than frontal. To understand the impairment, underlying mechanisms should be investigated. Although consolidation is one of these mechanisms consolidation phase of episodic memory in PD was not investigated yet. Recently accelerated long term forgetting (ALF) phenomenon is emphasized in consolidation researches. METHOD: Here it is evaluated the presence of accelerated long-term forgetting in nondemented PD as a consequence of a deficit in consolidation process. 32 patients and 33 controls participated in the study. Turkish Verbal Memory Process Test (VMPT) was applied to both groups. Delayed recall (DR) scores collected after 30 min, one week and six weeks. Forgetting rates were calculated based on these scores. RESULTS: There was significant difference in DR scores of patients compared to controls in the 30th minute and sixth week. Forgetting rate between 30th minute-1st week did not differ but 1st-6th week was found statistically significant across groups. CONCLUSIONS: To the best of our knowledge, this is the first study investigating verbal memory consolidation in PD. Results suggested that impairment is possibly related to the late phase of consolidation of verbal memory in neocortex.

Cognitive dysfunction of right hemisphere-like Todd's paralysis after status epilepticus: a case report.

We describe a case with symptoms of transient diffuse right hemisphere dysfunction (hemispatial neglect, dyscalculia, and disturbance of both spatial construction and visuospatial perception) occurring after status epilepticus. The clinical picture of this case suggested to us that these features could be understood as a variant of Todd's paralysis.

Ictal spitting during a left emporal lobe-originated complex partial seizure: a case report.

We present a 35-year-old male patient with intractable temporal lobe epilepsy in whom spitting automatism was documented by ictal recordings during seizures. Spitting is an uncommon automatism and occurs mainly with right-sided, nondominant, temporal focus. However, our patient had left mesial temporal sclerosis with nonverbal memory impairment, but intracarotid amobarbital test demonstrated language and memory dominance on the right hemisphere. The authors feel that this case supports the hypothesis of a nondominant, temporal lobe origin for the spitting automatism.

Association between APOE polymorphisms and mesial temporal lobe epilepsy with hippocampal sclerosis.

To evaluate the hypothetical link between apolipoprotein E (APOE) polymorphisms and mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) and whether presence of APOE epsilon4 allele shortens the latent period between febrile seizures and epilepsy. A further interest is whether presence of APOE epsilon4 allele has an impact on severity of the disease. Forty-seven patients with MTLE-HS were compared with 62 controls. APOE polymorphisms were determined from lymphocytes by standard methods. Eight patients (17%) and 10 controls (16.1%) were demonstrated to have one APOE epsilon4 allele. There was not any statistically significant difference in APOE epsilon4 frequency between patients and controls (P > 0.05). There was not any difference statistically according to onset age of epilepsy and the presence of APOE epsilon4 allele within patient group. APOE epsilon4 polymorphisms did not influence the severity of epilepsy. APOE epsilon4 polymorphisms had no impact on outcome after surgery. Patients with bilateral memory deficits, bilateral hippocampal atrophy and with bilateral epileptiform interictal EEG transients, were independently compared with patients having unilateral features and there were not any statistically significant differences. This study has found no association between APOE epsilon4 polymorphisms and presentation of MTLE-HS in a group of Turkish patients.

Surgical outcome of epilepsy patients evaluated with a noninvasive protocol.

Surgery is now an accepted treatment for some medically intractable epilepsies. Presurgical evaluation is particularly important for the localization of the epileptogenic zone, which may necessitate sophisticated imaging techniques and intracranial electroencephalogram (EEG) recordings. If patients are carefully selected, however, successful results can be achieved with noninvasive evaluation methods. Seventy-seven patients were operated on for intractable seizures. All patients underwent EEG, neuropsychological, psychiatric, and magnetic resonance imaging investigations. Ictal EEG-video recording was performed in all nonlesional and in some lesional cases that had discordant data. Selective amygdalo-hippocampectomy was performed on patients with mesial temporal lobe epilepsy (MTLE), an extended or a limited lesionectomy was performed on patients with structural lesions, and a lesionectomy with deafferentation was performed on two patients with West syndrome. Electrocorticography was not used. Temporal lobe directed surgery was performed in 63.6% of the cases. The pathological examinations of all cases showed hippocampal sclerosis (HS) in 43%, tumor or tumor-like lesions in 36%, and cortical dysplasia in 5% of patients. After a mean follow-up of 17 months (range, 2-53), 75% of the patients were seizure-free with or without aura and 15% had a marked improvement, whereas 10% did not benefit from surgery. Neuropsychological outcome of patients with MTLE and HS also showed worthwhile results. Our patients, who were evaluated without pre- and perioperative intracranial recordings and other sophisticated techniques, had an outcome comparable to those in other series from more experienced centers. Our experience indicates that successful results, especially for patients with MTLE-HS and lesion-related epilepsies, can be obtained at centers with limited resources if the diagnoses and evaluation procedures are performed carefully.