American Board of Internal Medicine (ABIM) Certification Practice Exam

What finding is likely in patients experiencing seizures due to refractory temporal lobe epilepsy?

1. Upper respiratory infections

2. Increased quality of sleep

3. Growth of small tumors

4. Improved cognitive function

The correct answer is: Improved cognitive function

In patients experiencing seizures due to refractory temporal lobe epilepsy, there is often a pattern of cognitive decline or impairment associated with ongoing seizure activity. Therefore, the most relevant finding is a potential deterioration in cognitive function rather than an improvement. It's important to note that refractory temporal lobe epilepsy is frequently linked to structural abnormalities in the temporal lobe, such as hippocampal sclerosis, and these conditions can significantly impact various cognitive domains, including memory and executive function. Patients may also experience psychosocial difficulties, which compound cognitive challenges. The other options suggest scenarios that are not typically associated with refractory temporal lobe epilepsy. For instance, upper respiratory infections are not directly linked to seizures in this context. Increased quality of sleep is unlikely as seizures often disrupt sleep patterns. The growth of small tumors, while possible in a broader sense, does not specifically pertain to the changes expected in refractory temporal lobe epilepsy cases, where structural changes have already occurred. Thus, focusing on cognitive function is essential for understanding the implications of refractory seizures.