Two-year follow-up of intelligence after pediatric epilepsy surgery.
Research findings concerning cognitive effects of pediatric epilepsy surgery form an important basis for decisions about surgery. However, most follow-up studies have been of limited duration. In this study, a 2-year follow-up of intelligence was undertaken. Risk factors were analyzed. Included were 38 patients aged 3 to 17 years. Surgery was left in 19 patients and right in 19 patients. Types of surgery included temporal lobe resection (n = 23), extratemporal or multilobar resection (n = 8), and hemispherectomy (n = 7). The Wechsler Scales of Intelligence were administered presurgically, 6 months postsurgically, and 2 years postsurgically. No significant change in verbal or performance intelligence quotient (IQ) was demonstrated on a group level. Lateralization, type of surgery, age at surgery, sex, and presurgical IQ did not affect outcome. Across assessments, IQ scores of left-hemisphere patients were lower than those of right-hemisphere patients. Scores of patients in the hemispherectomy group were lower than those of the extratemporal or multilobar resection group, which were lower than the temporal lobe resection group. Scores improved significantly in six patients and deteriorated in seven. In conclusion, epilepsy surgery in children and adolescents does not, in general, have a significant impact on cognitive development in a 2-year perspective. In individual patients, poor seizure control and extensive surgery for Rasmussen's encephalitis were related to a deterioration of IQ.
Korkman
Marit
M
Abo Akademi University, Turku, Finland.
Granström
Marja-Liisa
ML
Kantola-Sorsa
Elisa
E
Gaily
Eija
E
Paetau
Ritva
R
Liukkonen
Elina
E
Boman
Petra-Ann
PA
Blomstedt
Göran
G
D000293:Adolescent; D041923:Adolescent Development; D000367:Age Factors; D038481:Anterior Temporal Lobectomy; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D003071:Cognition; D004827:Epilepsy / Q000523:psychology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D038421:Hemispherectomy; D006801:Humans; D007360:Intelligence; D008297:Male; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome