title: Developmental outcome after epilepsy surgery in infancy.
abstract: OBJECTIVE
  Our goals were to determine the effect of epilepsy surgery in infants (<3 years of age) on development and describe factors associated with postoperative developmental outcome.
  
  
  METHODS
  We identified 50 infants among 251 consecutive pediatric patients (<18 years old) undergoing epilepsy surgery. Charts were reviewed for clinical data and neurodevelopmental testing with the Bayley Scales of Infant Development. A developmental quotient was calculated to compare scores of children at different ages.
  
  
  RESULTS
  Complete data were available on 24 of 50 infants. Surgeries included 14 hemispherectomies and 10 focal resections. Seventeen patients became seizure free; 5 patients had >90% seizure reduction, 1 had >50% seizure reduction, and 1 had no change. The developmental quotient indicated modest postoperative improvement of mental age. The preoperative and postoperative development quotients correlated well. Younger infants had a higher increase in developmental quotient after surgery. Patients with epileptic spasms were younger and had a lower developmental quotient at presentation, but increase in developmental quotient was higher in this subgroup.
  
  
  CONCLUSIONS
  After surgery, seizure frequency and developmental quotient improved. Developmental status before surgery predicted developmental function after surgery. Patients who were operated on at younger age and with epileptic spasms showed the largest increase in developmental quotient after surgery.
authors.affiliation: Department of Pediatric Neurology, Cleveland Clinic, Cleveland, OH 44195-5245, USA.
authors.forename: Tobias
authors.initials: T
authors.lastname: Loddenkemper
authors.forename: Katherine D
authors.initials: KD
authors.lastname: Holland
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Stanford
authors.forename: Prakash
authors.initials: P
authors.lastname: Kotagal
authors.forename: William
authors.initials: W
authors.lastname: Bingaman
authors.forename: Elaine
authors.initials: E
authors.lastname: Wyllie
mesh_terms: D002657:Child Development / Q000502:physiology; D002675:Child, Preschool; D004827:Epilepsy / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies