Abstracts

Despite increasing use of hemispherectomy for treating early onset intractable pediatric epilepsy (Devlin et al., 2003; Jonas et al., 2003; Lindsay et al., 1987; Vining et al., 1997), there is little information on the long-term behavioral outcome of these children based on established psychopathology instruments. Using such measures, this study examined the behavioral outcome and its association with surgical, seizure-related, and psychopathology variables 10-15 years after hemispherectomy. At long-term follow-up, the Kiddie-Schedule for Affective Disorders and Schizophrenia (Kaufman et al., 1997) was administered to 49 children who had surgery at age 5.0(SD 3.77) . Parents were also interviewed and completed the Child Behavior Checklist (CBCL) (Achenbach, 1991), Aberrant Behavior Checklist (ABC) (Einfeld [amp] Tongue, 1996), and Developmental Behavior Checklist (DBC) (Aman et al., 1994). Sixty-four percent of the children had a DSM-IV psychiatric diagnosis. Of these, 36% met criteria for psychosis NOS, 20% ofrt an affective/anxiety disorder, 4% attention-deficit-hyperactivity disorder, and 4% pervasive developmental disorder. Controlling for hemispherectomy type (ie, functional, anatomical, hemispherotomy) and neuropathology (ie, cortical dysplasia, Rasmussen encephalitis, infarct, other), the children with psychosis had significantly greater intraoperative blood loss per kg than those without psychosis ([underline]p[/underline] [lt] .009). Surgical and seizure-related variables, as well as CBCL, DBC, and ABC scores were unrelated to the presence of psychosis. Increased intra-operative blood loss might make children more vulnerable to psychosis at long-term post-hemispherectomy follow-up. Structured psychiatric interviews rather than commonly used parent report behavioral instruments identify children with psychosis following hemispherectomy. (Supported by NS 39505.)