Reasoning, Remembering, and Academics in Children with Epilepsy: Does Surgery Make a Difference?
Abstract number :
B.12
Submission category :
Year :
2000
Submission ID :
3334
Source :
www.aesnet.org
Presentation date :
12/2/2000 12:00:00 AM
Published date :
Dec 1, 2000, 06:00 AM
Authors :
Mary Lou Smith, Lucyna M Lach, Irene M Elliott, Univ of Toronto at Mississauga, Mississauga, ON, Canada; Hosp for Sick Children, Toronto, ON, Canada.
RATIONALE: Studies examining the Neuropsychological outcome of epilepsy surgery typically compare performance after surgery with that of a pre-surgical baseline. While this approach is informative, it does not control for effects of repeated testing. Furthermore, if the results indicate no change in neuropsychological performance after surgery, one does not know whether there would also have been stability without surgery. To address these issues, we investigated outcome after surgery in children and included a control group with intractable epilepsy. METHODS: 31 children (mean age = 12.5 , range 7-17 years) with intractable seizures were recruited from an epilepsy-monitoring program. Surgical candidates (n = 17, 12 temporal, 5 extratemporal) were tested prior to surgery and one year after surgery. The control group (n = 14) was tested twice, also with one year between assessments. Standardized measures of intelligence, verbal memory, visual memory, and academic skills were administered. RESULTS: At baseline, the two groups were comparable in age, age of onset of seizures, sex, and number of AEDs. Any significant changes in group means over the year were small in magnitude but represented declines in performance; these results were found for a measure of distractibility on the IQ test (p<.03), reading decoding (p<.05), and in a trend on verbal intelligence (p<.08). Predictors of individual change varied across measures, but improvements were more likely to be seen with temporal than extratemporal lesions. Greater improvement in memory was found in girls, but boys showed larger gains in spelling. Laterality of lesion had no effect on outcome. CONCLUSIONS: This study is unique in the evaluation of surgical outcome in that it includes a control group. The results suggest that epilepsy surgery does not result in changes in cognitive performance beyond those seen over time in children with intractable seizures. While these results are positive in indicating no cognitive risks of surgery, they also imply that benefits of surgery on cognitive performance should not be expected, at least in the first year. Funded by the Ontario Mental Health Foundation.