Classics in epilepsy and behavior: commentary.

In 1958, Dr. Francis M. Forster became the Chairman of the Department of Neurology at the University of Wisconsin Medical School. In developing the Department, Forster decided to add a section of neuropsychology, a relatively new clinical specialty, and in retrospect a bold move. Forster selected Halgrim Klove to direct the Neuropsychology Lab, and one of Hal s first faculty hires was Charles Matthews. Having completed postdoctoral training with Dr. Ralph Reitan in Indianapolis, Chuck was working at Fort Wayne State Hospital in Indiana. He joined the Department of Neurology in 1962, and subsequently began one of the longest standing training programs in clinical neuropsychology in the United States. Klove and Matthews shared many research interests, but none more so than epilepsy. Together, and then later with a succession of talented fellows and students, they began to map out the neuropsychological consequences of the epilepsies in a systematic and comprehensive fashion. The relationship between cognitive function and clinical seizure variables, such as seizure type, age of onset, duration of epilepsy, and antiepilepsy medications, had been a topic of interest for some time. Earlier studies focused predominantly but not exclusively on IQ, perhaps the best example being the work of William Lennox and collaborators. One of the major contributions of Klove and Matthews and their students was to examine patients using comprehensive measures of higher cortical functioning, specifically, the neuropsychological procedures initially developed by Ward Halstead and later refined by Ralph Reitan—the socalled Halstead–Reitan Battery. Other contributions included their careful and systematic study of seizure type broken down by etiology, and use of control groups consisting of patients with ‘‘verified brain damage’’ but without epilepsy so that the effects of the seizures and treatment could be dissociated from the underlying cerebral lesion. The environment at Wisconsin was excellent and the support and collaboration from faculty such as Forster, Hal Booker, and others contributed to their success in epilepsy research. In this paper, their first together, Klove and Matthews compared healthy controls with patients with epilepsy of known and unknown etiology (matched for seizure type) and a group without epilepsy but with underlying cerebral lesions/disease. The groups were compared on tests of intelligence (Wechsler–Bellevue Form 1) and Halstead s measures of ‘‘adaptive abilities.’’ As a result of their findings, they concluded that ‘‘the presence of epileptic seizures was associated with lower psychometric and adaptive ability levels than those found in normal control subjects. . .. These results suggested that epileptic manifestations, regardless of etiology, resulted in significant impairment of adaptive and psychometric abilities, but that in those in whom verified lesions could be established, the ictal episodes per se did not result in significant cognitive impairment when compared to non-epileptic patients matched for type of pathology.’’ The subsequent independent and collaborative work of Klove and Matthews continued to refine the understanding of the role of seizures, underlying etiology, medication treatment, and other clinical seizure variables on neuropsychological status. Chuck s last epilepsy publication, co-authored with Carl Dodrill, appeared in 1992. Hal turned his interest to other issues in neuropsychology, maintaining a very active clinical and academic career. Epilepsy & Behavior 4 (2003) 365