Topographical orientation refers to the ability of the individuals to find their way around by using a variety of cognitive strategies during navigation. Here, we report six case studies of patients who underwent selective amygdalo-hippocampectomy (as treatment for severe temporal lobe epilepsy) in order to shed more light on the role of the medial temporal lobe (MTL) in adopting different strategies useful for orientation. Patients were submitted to a comprehensive assessment of topographical orientation skills in which they were asked to perform different spatial orientation tasks. The performance of each patient is discussed within his/her neurological context in order to provide a better understanding of the effects of amygdalo-hippocampectomy on the human ability to orient. The general conclusions support the critical role of medial temporal lobe structures in processing allocentric spatial information useful for creating cognitive maps, as opposed to the use of egocentric spatial information that are mostly involved in navigating while relying on body turns and sequences. These findings may have significant implications in developing rehabilitation programs for patients undergoing selective amygdalo-hippocampectomy.
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