Abstracts

Rationale: The rationale of this study is to characterize general cognitive ability in a large cohort of children with surgical temporal lobe epilepsy. Methods: 110 children under the age of 16 years with surgically treatable temporal lobe epilepsy defined by presurgical evaluation with video EEG monitoring and MRI evaluation underwent age appropriate developmental testing prior to surgery. Results: Patients were stratified by age: 16 were under age 3 yrs, 24 between 3-7 yrs, 35 between 7-12 and 41 between 12-16 yrs. Pathologies were age specific -hippocampal sclerosis was only seen twice <3 yrs, and in 15 patients in 12-16 year age group, while developmental tumors made up >50 % in each age group. The next frequent pathology was malformation of cortical development. IQ of <70 was measured in 69% < age 3 years, 57% age 3-7 years, 54% age 7-12 years, 44% age 12-16 years. More profound retardation (<50) was seen in up to 45% in the 2 younger patient groups up to 7 years, however 11% of 12-16 year old patients were moderately to severely retarded with IQ under 50. Conclusions: Temporal lobe epilepsy is associated with significant impairment of general cognitive ability across the ages in this group of children. There was an age related vulnerability in that younger children were more severely impaired. Despite localized seizure onset and circumscribed pathology temporal lobe seizures are significantly associated with impaired cognitive ability. This has basic implications for optimizing surgical and nonsurgical therapies.