Feeling-of-knowing in temporal lobe epilepsy: monitoring knowledge inaccessible to conscious recall.

Feeling-of-Knowing was compared in left temporal, right temporal, and control subjects. Seizure patients, like controls, demonstrate knowledge of information that is not accessible to conscious recall, but they are less accurate in FOK judgements. Furthermore, there are significant differences between seizure patients and controls in the relationship between Feeling-of-Knowing and object level memory scores: (1) Controls spend more time searching memory for inaccessible information that is correctly identified on a later recognition test than they do for information that is incorrectly recognized. (2) Latency of correct recognition decreases as strength of FOK increases among controls, suggesting that controls correctly anticipate the outcome of memory search. These patterns of performance, which are consistent with an efficient memory search termination device, were not observed among seizure patients. The findings suggest that inaccurate Feeling-of-Knowing may play a role in inefficient memory search mechanisms in temporal lobe epilepsy.