What's the impact of anterior temporal lobe epilepsy in faces perception?

Estimates of the risk of decline in specific neuropsychological domains after epilepsy surgery assist surgical decision making in clinical practice. Face perception is a critical brain function, essential to social interac- tions. Neuropsychological and neuroimaging studies have recently pointed out the critical role of the anterior temporal lobe in face percep- tion. Nevertheless, no studies have examined in details the impact of anterior temporal lobe epilepsy (ATLE) and its surgical therapy (anterior temporal lobectomy) on face perception. The aim of this study was to assess face perception performances in patients with left and right ATLE. We included 26 patients with refractory ATLE (15 right, 11 left) as well as 26 matched controls. Patients and controls subjects performed tests on face detection, individual face discrimination and famous face recognition. Overall, left ATLE patients showed normal performances on face per- ception. In the right ATLE group, one half showed normal performances and the other half was severely impaired. In this group, an effect of epilepsy duration is observed. At me moment, 10 ATLE (8 right, 2 left) were also tested after surgery and we did not find any significant decline. Our results show that right ATLE impairs face perception perfor- mances and that this impairment increases with epilepsy duration. These results argue for an early surgical therapy in right ATLE and also for a systematic neuropsychological evaluation of face perception perfor- mances in these patients.