THE UTILITY OF THE WARRINGTON RECOGNITION MEMORY TEST FOR TEMPORAL-LOBE EPILEPSY - PREOPERATIVE AND POSTOPERATIVE RESULTS

We wished to examine the ability of the Warrington Recognition Memory Test (RMT) to distinguish epilepsy of left versus right temporal lobe origin during preoperative testing and to assess pre- to postoperative changes in memory function after anterior temporal lobectomy (ATL). Seventy-seven patients were assessed preoperatively and 6-8 months postoperatively. Patients' performance for verbal (Words) and nonverbal (Faces) material was examined with raw, scaled, and discrepancy scores, as well as with more formal diagnostic efficiency statistics and receiver operating characteristic (ROC) curves. Preoperatively, no aspect of the RMT could reliably distinguish left from right temporal lobe epilepsy groups. Examination of pre- to postoperative memory change showed declines in Word recognition memory after left ATL and less consistent declines in Face recognition memory after right ATL. Diagnostic efficiency statistics demonstrated poor classification ability preoperatively and improved classification ability postoperatively. We conclude that the RMT is not insensitive to lateralized temporal lobe lesions (as demonstrated by the pre- to postoperative performance changes), but it is of extremely limited clinical utility in identifying laterality of temporal lobe seizure onset preoperatively The reasons for this interesting pattern of results are discussed.