Abstracts

Rationale: Chronic intractable epilepsy is associated with cognitive dysfunction in both adults and children. Often times cognitive dysfunction improves with seizure control. Despite improved seizure control, epilepsy surgery is associated with deterioration in verbal memory scores in adult patients. On the other hand, children have increased functional plasticity of the brain which we hypothesize may prevent the cognitive decline associated with resective epilepsy surgery in adults. This study is being done to evaluate outcomes of intelligence quotients (full scale, performance and verbal) and achievement (reading, math spelling) among pediatric patients who underwent seizure focus resection. Methods: Seizure frequency, number of medications taken, verbal, full scale, and performance IQs as well as reading, math, spelling were assessed before and after resection of seizure focus in 12 patients. Results were analyzed with student’s t-table test. Results: Ten out of twelve patients (83.3%) showed reduction in seizure frequency while four out twelve patients (33.3%) had a reduction in the number of medications being taken after surgery. The reduction in the frequency of seizures as well as number of medications after epilepsy surgery is statistically significant (significance level of 0.009 and 0.019 respectively). No statistical difference was noted pre- versus post- resection in the group for Verbal (VIQ), Performance (PIQ) or Full scale (FSIQ) intelligence quotients. A trend toward improvement was noted in Verbal and Full scale IQs. Seven out of ten patients (70%) were stable or showed improvement in Verbal IQ after surgery. Five out of 12 patients (41%) demonstrated stable or improved full scale IQ and forty percent (4 out of 10 patients) had stable or improved Performance IQ after surgery. In patients who had left sided resections, 60% had stable or improved Verbal IQ, compared to 80% on patients with right side resections, but results are not statistically significant. Math, reading and spelling scores before and after surgery were not significantly different. Conclusions: Surgical resection for epilepsy significantly reduced the frequency of seizures and number of medications in our patients. No significant differences in Verbal, Full Scale and Performance IQs pre- versus post- resection, were seen in this small sample of patients. Additionally, there was a trend towards improvement in Verbal and Full scale IQs. There are no significant changes noted in reading, spelling and math scores after surgery. Further expansion of our sample population is necessary to validate these findings.