We appreciate the thoughtful comments by Schofield and Nielsen regarding our investigation of the neuropsychological features of the syndrome of MTLE.1 Their letter refers to the definition and assessment of EF, and they would have preferred that we assessed the domain of EF with additional measures that would have more adequately represented its complex and multifaceted features. While we do not agree that some of the measures suggested by Schofield and Nielsen are primarily reflective of EF, our disagreement only serves to support their point that EF is a poorly defined construct whose definition needs to be clarified to prevent further ambiguity. The observations and comments of Schofield and Nielsen do not detract from the major thrust of our investigation, ie, that patients with MTLE presenting for surgical consideration as adults exhibit evidence of generalized cognitive dysfunction. Whether generalized cognitive impairments would be seen in younger patients with MTLE would help to clarify issues related to optimal timing of anterior temporal lobectomy.
Hermann B. Mesial Temporal Lobe Epilepsy—Reply. Arch Neurol. 1998;55(5):754. doi: