Seizure Burden, Cognitive Outcomes and Medication Reduction Following Pediatric Epilepsy Surgery: A Single Institution Experience
Abstract number :
1.458
Submission category :
9. Surgery / 9B. Pediatrics
Year :
2024
Submission ID :
1342
Source :
www.aesnet.org
Presentation date :
12/7/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Timothy Ainger, PhD – University of Kentucky
Patricia Bacus, MD – University of Kentucky
Rachel Ward Mitchell, RN – UK HealthCare
Zahra Haghighat, MD – University of Kentucky
Meriem K. Bensalem-Owen, MD, FACNS, FANA – University of Kentucky
Rationale: Pediatric epilepsy surgery has emerged as an important treatment option for drug-resistant epilepsy in children. The goals of surgery include improving seizure control, enhancing the quality of life for both patient and caregiver, and reducing medication required for seizure control. Epilepsy surgery remains underutilized, and the long-term effects on cognitive development and medication dependency remain areas of active investigation
Methods: We conducted a retrospective review of medical records from children who underwent epilepsy surgery at the University of Kentucky between 2014-2024. Cognitive outcomes were evaluated using standardized neuropsychological assessments administered pre- and post-operatively when feasible. Seizure control and burden were evaluated based on frequency and severity of seizures, as well as anti-seizure medication (ASM) adjustments over time.
Results: Over a decade 20 patients, ages 21 days to 18 years underwent epilepsy surgery. The most frequent pathologies encountered included focal cortical dysplasia or neoplasms. Some patients’ post-surgical cognitive assessments reflected significant improvements; however, the majority of patients continued to perform below average across various cognitive domains. This finding appeared to be exacerbated by the presence of lower presurgical baseline and/or the presence of a neurodevelopmental diagnosis. Approximately 50% of patients had a significant seizure reduction to allow ASM reduction. No clear documentation was seen about quality of life for patient and caregiver. Limiting factors in the analysis included the retrospective nature of the review, an enterprise-wide change in the electronic medical record system which limited access to medical information, and patients lost to follow-up care.
Conclusions: Through this retrospective insight we reviewed the need and importance of comprehensive follow-up for pediatric epilepsy surgery patients including a systematic documentation of standardized evaluations pre- and post-operatively for cognitive evaluation, assessment of patients’ and caregivers’ quality of life, and seizure and treatment burden.
Funding: none
Surgery