Anterograde amnesia recurrence in temporal lobe epilepsy with amygdala-enlargement

BMJ Case Rep. 2024 Dec 27;17(12):e262302. doi: 10.1136/bcr-2024-262302.

Abstract

Temporal lobe epilepsy (TLE) can cause different types of memory impairments. Here, we report a case of immediate improvement of memory impairment following antiepileptic drug (AED) treatment in a patient with TLE with amygdala enlargement (TLE-AE), who rapidly developed recurrence. The patient was a man in his 60s whose family members complained of his amnesia. Neuropsychological investigations detected obvious recent and remote memory loss and executive function impairments. Our examinations revealed evidence of TLE and bilateral amygdala enlargement without any results suggesting organic diseases, resulting in a diagnosis of TLE-AE. Although treatment with levetiracetam immediately improved recent memory and executive function, the improvement of the former was temporary. His recent memory loss impairments recurred within 3 months, but were recovered again after switching drug treatment to lacosamide and suppressing epileptic seizures. Careful follow-up after starting AED and sufficient AED adjustment is important in the treatment of memory problems in TLE-AE.

Keywords: Epilepsy and seizures; Memory Disorders; Memory disorders (psychiatry); Neurology; Psychiatry.

Publication types

  • Case Reports

MeSH terms

  • Amnesia, Anterograde* / drug therapy
  • Amnesia, Anterograde* / etiology
  • Amygdala* / diagnostic imaging
  • Amygdala* / pathology
  • Anticonvulsants* / therapeutic use
  • Epilepsy, Temporal Lobe* / drug therapy
  • Humans
  • Lacosamide / therapeutic use
  • Levetiracetam* / therapeutic use
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Recurrence*

Substances

  • Anticonvulsants
  • Levetiracetam
  • Lacosamide