Developmental outcomes of childhood-onset temporal lobe epilepsy: a community-based study.
OBJECTIVE
To assess the impact of childhood-onset temporal lobe epilepsy (TLE) on the attainment of normative developmental tasks and identify predictors of long-term developmental outcomes.


METHODS
In 1992-1993, a prospective longitudinal cohort study of childhood-onset TLE was commenced in the State of Victoria, Australia. At review in 2004-2006, we assessed developmental tasks, which are age-specific individual psychosocial achievements tied to particular phases of the lifespan. The cohort comprised 54 individuals (33 female) with a mean age of 20 years (range 12-29), and mean age at TLE onset of 6 years (range 0.2-15).


RESULTS
Individuals were clustered into three groups representing distinct developmental trajectories: (1) a Normal group (52%) who achieved most of their developmental tasks, (2) an Altered group (37%) who achieved some, and (3) a Delayed group (11%) who achieved few. The groups showed significant cognitive differences, with the Normal group outperforming the Altered and Delayed groups on a range of measures (p < 0.05). Multiple discriminant function analysis indicated that membership of the groups was independently predicted by the chronicity of seizures, cognitive functioning, having surgically remediable epilepsy, and gender (p < 0.001). Seizure chronicity and cognition discriminated between all three trajectories, while surgical intervention and gender primarily discriminated between the Altered and Delayed trajectories.


CONCLUSIONS
Childhood-onset TLE can disrupt achievement of normative developmental tasks that is independently predicted by medical, biologic, and cognitive factors. Assessment of developmental tasks across the lifespan provides a practical framework for guiding prognostic counseling of patients and families.
Melbourne School of Psychological Sciences, The University of Melbourne, Victoria, Australia. sarahw@unimelb.edu.au
Sarah J
SJ
Wilson
Silvana
S
Micallef
Asawari
A
Henderson
Genevieve
G
Rayner
Jacquie A
JA
Wrennall
Claire
C
Spooner
A Simon
AS
Harvey
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002657:Child Development / Q000502:physiology*; D015331:Cohort Studies; D004833:Epilepsy, Temporal Lobe / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012111:Residence Characteristics; D016896:Treatment Outcome; D055815:Young Adult