Subject(s)
Brain Neoplasms/surgery , Decompression, Surgical , Fornix, Brain/surgery , Mental Recall , Pineal Gland/surgery , Pinealoma/surgery , Amnesia/complications , Amnesia/diagnosis , Amnesia/surgery , Brain Neoplasms/complications , Brain Neoplasms/diagnosis , Decompression, Surgical/trends , Female , Fornix, Brain/pathology , Humans , Middle Aged , Pineal Gland/pathology , Pinealoma/diagnosisABSTRACT
OBJECTIVE: We present the case of a professional jazz guitarist with temporal lobe epilepsy secondary to an arteriovenous cerebral malformation. CASE DESCRIPTION: The patient underwent a left temporal lobectomy in 1980. After surgery, he presented with severe retrograde amnesia and complete loss of musical interest and capabilities. The patient's musical abilities recovered over time, and he regained his previous virtuoso status. In 2007, his medical history, neuropsychologic functions, and structural magnetic resonance imaging study were examined and revealed a remarkable degree of recovery of memory and musical abilities in the context of extensive temporal lobe resection. The neuropsychologic findings and neuroanatomic features of the magnetic resonance imaging study were analyzed to try to understand the high degree of recovery of both long-term memory and musical processing abilities in this musician. CONCLUSIONS: This case reveals the possibility of an unusual degree of cerebral plasticity and reorganization. Additionally, it emphasizes the question of musical virtuosity. This report shows that the musical capabilities of professional musicians, in specific cases, can completely recover even when much of the left temporal lobe has been removed.
Subject(s)
Amnesia/surgery , Epilepsy, Complex Partial/surgery , Headache/surgery , Intracranial Arteriovenous Malformations/surgery , Music , Neurosurgical Procedures , Adult , Amnesia/etiology , Amnesia/pathology , Epilepsy, Complex Partial/etiology , Epilepsy, Complex Partial/pathology , Headache/pathology , Humans , Intracranial Arteriovenous Malformations/complications , Intracranial Arteriovenous Malformations/pathology , Magnetic Resonance Imaging , Male , Recovery of Function , Temporal Lobe/pathology , Temporal Lobe/surgerySubject(s)
Amnesia/surgery , Mental Recall/physiology , Neurosurgical Procedures/methods , Aged , Female , Humans , Neuropsychological TestsABSTRACT
One memory disorder that is potentially treatable with antiepileptic drugs is transient epileptic amnesia (TEA). Working diagnostic consensus criteria for TEA include: (1) a history of recurrent witnessed episodes of transient amnesia; (2) confirmation by a reliable witness that cognitive functions other than memory are intact during typical episodes; and (3) evidence for a diagnosis of epilepsy. We describe a case with both complex partial seizures and episodes of TEA. This is the first reported case of a neurosurgical intervention for symptoms resembling those described in refractory TEA. Video/EEG, 3-T MRI, neuropathology, and neurological as well as neuropsychological findings are presented with postsurgical clinical outcome. The patient underwent right anterior amygdalohippocampectomy for symptoms resembling refractory TEA with additional complex partial seizures at our epilepsy surgical center. She remained seizure free at the 15-month follow-up, and memory complaints remitted. This case report illustrates one memory disorder, transient epileptic amnesia, that is potentially treatable with antiepileptic drugs or surgery.
