Greater functional recovery after temporal lobe epilepsy surgery in children.
The purpose of our study is to evaluate whether children recover better than adults from memory deficits as a consequence of temporal lobe surgery. We compared 3 and 12 month outcomes obtained in children and adults with medically refractory epilepsy. Each candidate underwent temporal lobe resection for seizure control and children were matched with regard to pathology, onset of epilepsy, side of surgery and type of surgery with adults (N = 30 for each group, mean age at surgery 13 versus 30 years). Three months after surgery, both left-resected groups displayed a significant decline in verbal learning capacity. During the following 9 months, only the children recovered and were able to reach their preoperative level 1 year after surgery. The left-resected adults remained, for the most part, on their low level and one year after surgery, they were still significantly worse than at the time of their preoperative examination. The right-resected adults experienced a deterioration in visual memory 1 year after surgery relative to the results of the short-term follow-up; the children improved. The children also had a better outcome with regard to attentional functions and, as a trend, a better seizure outcome (Engel Outcome I--1 year after surgery: 63% adults, 80% paediatric patients). Our neuropsychological data provide evidence of greater plasticity and compensational capacity in childhood. The results can be taken as a strong argument for early surgical intervention.
Gleissner
U
U
Department of Epileptology, University of Bonn, Bonn, Germany. ulrike.gleissner@ukb.uni-bonn.de
Sassen
R
R
Schramm
J
J
Elger
C E
CE
Helmstaedter
C
C
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000523:psychology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007858:Learning; D008297:Male; D008568:Memory; D009483:Neuropsychological Tests; D011184:Postoperative Period; D020127:Recovery of Function; D012640:Seizures; D013702:Temporal Lobe / Q000601:surgery*; D016896:Treatment Outcome