Impact of pediatric epilepsy surgery on intellectual efficiency.
BACKGROUND
Epilepsy surgery may be a promising alternative therapy for seizure control in patients with refractory seizures, resistant to medication. Cognitive outcome is another important factor in favor of the surgical decision.


OBJECTIVE
To investigate the correlation between seizure outcome and cognitive outcome after epilepsy surgery in a pediatric population.


METHODS
A total of 59 pediatric patients were retrospectively assessed with the WISC-III (Full Scale, Verbal Scale and Performance Scale) before and, at least, 6 months after surgery. Patients were divided into two groups according whether or not improvement of seizure control after surgery. Data collected for each child included: epileptic syndrome, etiology, age at epilepsy onset, duration of epilepsy and seizure frequency.


RESULTS
Comparison using a MANOVA test revealed significant differences across pre-operative Full Scale, Verbal Scale and Performance Scale (p = 0.01) with seizure reduction group performing better than no seizure reduction group. Seizure improvement group achieved significant Performance Scale improvement (p = 0.01) and no seizure improvement group showed significant Verbal Scale worsened after surgery (p = 0.01).


CONCLUSIONS
Our results suggest that the success of the epilepsy surgery in childhood when the seizure control is achieved may also provide an improvement in the Performance Scale whereas the seizure maintenance may worsen the Verbal Scale.
Department of Neuroscience and Behavioral Sciences, Universidade de Sao Paulo, Sao Paulo, Brasil. cecilia@rnp.fmrp.usp.br
Cecília
C
Souza-Oliveira
Sara
S
Escorsi-Rosset
Vera C
VC
Terra
Marino
M
Muxfeldt-Bianchin
Hélio R
HR
Machado
Américo C
AC
Sakamoto
D000293:Adolescent; D002648:Child; D003072:Cognition Disorders / Q000209:etiology*; D004569:Electroencephalography; D004827:Epilepsy / Q000601:surgery*; D005260:Female; D006801:Humans; D007360:Intelligence; D007361:Intelligence Tests; D008297:Male; D009483:Neuropsychological Tests; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D016896:Treatment Outcome