title: Remembrance and time passed: Memory outcomes 4-11 years after pediatric epilepsy surgery.
abstract: Little is known about the long-term cognitive outcomes following pediatric epilepsy surgery. Although the evidence for change within the first 2 years is not compelling, the plasticity of the immature brain may allow for improvements in the long term. This study examined memory function in a cohort of surgical and nonsurgical patients at baseline and 4-11 years after.
  
  
  
  Participants were 88 patients (mean age 20.05, standard deviation [SD] 4.21 years) with childhood-onset intractable epilepsy; 53 had undergone resective epilepsy surgery. Verbal and visual memory were assessed at baseline and follow-up using standardized tests of recall of stories, faces, word pairs, and word lists.
  
  
  
  Improvements over time were not found; outcomes were largely independent of surgical status. Those who were seizure-free at follow-up had better story recall at both times (p = 0.028), and did not show improvement. Among patients with extratemporal lobe epilepsy, significant declines in word list recall were found over time irrespective of surgical or seizure status (p = 0.010). Effects of laterality of seizure focus were evident only when examining patients with temporal lobe epilepsy (TLE); patients with left TLE had lower story recall scores compared to patients with right TLE at long-term follow-up (p = 0.043).
  
  
  
  Patients who became seizure-free had some advantages in memory, but did not show improvements over time. These findings have important implications for understanding potential outcomes from surgery or continued use of antiepileptic medications.
authors.affiliation: Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Klajdi
authors.identifier: 0000-0001-7763-988X
authors.initials: K
authors.lastname: Puka
authors.affiliation: Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada.|Department of Psychology, University of Toronto Mississauga, Mississauga, Ontario, Canada.|Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Mary Lou
authors.initials: ML
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D004827:Epilepsy / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000209:etiology*; D011939:Mental Recall; D009483:Neuropsychological Tests; D013997:Time Factors; D055815:Young Adult
keywords: Children; Cognition; Long-term; Temporal lobe