Rehabilitation of Cognitive Disorder After Temporal Lobe Epilepsy Surgery: Proposal for a Protocol

Objectives: Surgical intervention is a crucial and effective treatment option for patients with temporal lobe epilepsy whose seizures are not under con-trol. However, there is a possibility that surgical intervention may have a negative effect on cognitive functions. Cognitive rehabilitation is a treatment option that has been recently investigated for various neurocognitive problems. This study proposes a protocol for the rehabilitation of the cognitive dysfunctions after temporal lobe epilepsy surgery. Methods: To overcome the cognitive deficits that occurred after surgery, a six-step program was developed, which included the compensatory and adaptation strategies and memory and executive functions. This program was performed after epilepsy surgery in two patients who were evaluated with neuropsychometric test battery. Results: Cognitive rehabilitation program had a significant and positive effect on the neuropsychometric test results in two epilepsy patients who had postoperative attention, memory and executive function problems. Discussion: In the postoperative period, patients with temporal lobe epilepsy may be able to recover from cognitive disorders with an effective CR program. Although our results were obtained only with two patients, they suggest that cognitive rehabilitation had a significant and positive effect on epilepsy patients with postoperative attention, memory and executive function problems. However, the onset of the rehabilitation before or after surgery, the duration and the content of the rehabilitation are controversial issues. Conclusion: Future studies should show evidence basis of the standardized rehabilitation program for patients after epilepsy surgery, and the short and long-term effects of the rehabilitation with larger participants.