Cognitive, psychosocial, and family function one year after pediatric epilepsy surgery.
OBJECTIVE
Assumptions regarding the benefits of seizure control after pediatric epilepsy surgery for cognitive, psychosocial, and family function were explored in a prospective study of 51 children with intractable epilepsy.


METHODS
Thirty children who underwent surgery were studied before and 1 year after surgery, and a comparison group of 21 children with medically refractory seizures was examined at comparable times.


RESULTS
One year after surgery, 57% of the surgical group was seizure free. Seizure status after surgery did not predict change over time in any of the areas measured. Cognitive and psychosocial status did not change over time in either group, and the strongest predictor of individual change in psychosocial status in the surgical group was baseline level of function. Within the surgical group, a trend toward an increase in independence promotion was noted in the family, but the children's satisfaction with the family declined.


CONCLUSIONS
These findings challenge the assumption that elimination of seizures will result in improved cognitive, psychosocial, and family functioning, at least within the first year after surgery.
Smith
Mary Lou
ML
Department of Psychology, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada. smithml@psych.utoronto.ca
Elliott
Irene M
IM
Lach
Lucyna
L
D000223:Adaptation, Psychological / Q000502:physiology*; D000293:Adolescent; D000367:Age Factors; D002540:Cerebral Cortex / Q000601:surgery*; D002648:Child; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology; D004827:Epilepsy / Q000523:psychology* / Q000601:surgery*; D004833:Epilepsy, Temporal Lobe / Q000523:psychology / Q000601:surgery; D005192:Family Health; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000175:diagnosis / Q000523:psychology; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012917:Social Adjustment; D013702:Temporal Lobe / Q000601:surgery; D016896:Treatment Outcome