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Sallie Baxendale

Publications and source records attributed to Sallie Baxendale.

6 recordsLinked to original sources
PubMed2006

Predicting memory decline following epilepsy surgery: a multivariate approach.

BACKGROUND: While some patients experience a decline in memory function following an anterior temporal lobe resection, there is considerable individual variation in the extent, nature, and direction of postoperative memory change. Patients with surgically remediable temporal lobe epilepsy differ in etiology, the extent and type of underlying pathology, and on demographic and epilepsy-related variables, all of which may have an impact on their pre- and postoperative neuropsychological functioning. This study examined the relationship between these variables and postoperative memory decline. METHODS: Logistic regression was used to examine the effects of age, laterality of surgery, age of onset of epilepsy, underlying pathology and preoperative level of memory function on postoperative verbal learning in 288 patients who had undergone an anterior temporal lobe resection. One hundred twenty-five patients underwent a right temporal lobe resection (RTL), 163 patients underwent a left temporal lobe resection (LTL). RESULTS: In the group as a whole, 25% of the patients demonstrated a significant postoperative deterioration in verbal learning. Postoperative deterioration in verbal learning was significantly associated with higher levels of preoperative function in both the RTL and LTL groups. Older age at the time of the operation and a lower verbal IQ were additional significant predictors for the RTL group. The presence of cortical dysgenesis was a significant predictor of postoperative decline in the LTL group. The logistic regression models accurately identified 3/4 of those who experienced a postoperative decline in memory, using a cutoff of 0.25 or above to identify high risk. CONCLUSIONS: Our analyses suggest that the majority of patients with a high risk of significant postoperative memory decline can be reliably identified preoperatively. These models are valuable tools helping patients make an informed decision regarding surgery.

Epilepsy↗
PubMed2005

Defining meaningful postoperative change in epilepsy surgery patients: measuring the unmeasurable?

Two hundred and ninety epilepsy surgery patients completed the Hospital Anxiety and Depression Scale and were assessed on a list learning task preoperatively and 1 year postoperatively. Deterioration and improvement in verbal memory were determined using reliable change indices (RCIs) at 80 and 90% confidence limits. Almost one third of patients (27%) experienced a deterioration in verbal learning. The number of left temporal lobectomy patients who had deteriorated outnumbered the right temporal lobectomy patients by 2:1. Significant improvements in verbal learning were seen in 21% of the right temporal lobectomy group and 10% of the left temporal lobectomy group. Patients who were seizure-free postoperatively were not more likely to experience a postoperative deterioration or improvement in memory than those who continued to experience seizures. No significant relationships were found between subjective ratings of postoperative memory function and objective indices of change. Reliable, objective indices of postoperative deterioration in memory function may bear little relation to the patient's subjective experience. This should be considered when statistical predictions are used as the basis of preoperative counseling.

Adult↗
PubMed2003

Epilepsy at the movies: possession to presidential assassination.

In this review I examine the portrayal of epilepsy, seizures, and non-epileptic attack disorder in 62 movies produced over three-quarters of a century, across four continents, covering nine cinematic genres. While similar reviews of epilepsy in literature have suggested a progression in the understanding of epilepsy over time, this survey of the newer medium found examples of all of the ancient beliefs about epilepsy including demonic or divine possession, genius, lunacy, delinquency, and general "otherness". Nevertheless there has been a progressive trend towards more overt depictions of epilepsy. Male characters with idiopathic epilepsy tend to be mad, bad, and commonly dangerous, whereas characters with post-traumatic epilepsy are usually cast as heroes triumphing against the odds. Epilepsy in female characters tends to signify exotic vulnerability. The dramatic potential of seizures remains highly tempting to film writers and directors alike. Although it is not for the medical profession to dictate or censor cinematic content, a keen eye on these depictions will help us to understand and perhaps combat some of the stereotypes and myths that continue to surround epilepsy in the 21st century.

Epilepsy↗
PubMed2002

The role of functional MRI in the presurgical investigation of temporal lobe epilepsy patients: a clinical perspective and review.

Speculation regarding the role that fMRI might play in the presurgical assessment of temporal lobe epilepsy patients began almost as soon as the technology was introduced. Much of this speculation centred on hopes that fMRI might eventually supersede the invasive intracarotid amobarbital procedure (IAP). This review examines the progress that has been made to date towards this aim. A decade after its inception, fMRI paradigms that reliably lateralize language dominance have been established. However, fMRI has yet to achieve its full potential in the mapping of clinically relevant language skills in presurgical epilepsy patients. The role of fMRI in the assessment of postoperative amnesic risk is more complex. The results from recent fMRI memory studies in people with epilepsy have been encouraging. However, as yet, fMRI techniques cannot be used alone to confidently assess the risk of a postsurgical amnesic syndrome. It seems probable that these techniques will continue to be combined with traditional neuropsychological assessment and information from structural MRI studies and the other presurgical investigations to assess postoperative amnesic risk.

Amobarbital↗