title: Pediatric Epilepsy Surgery: The Prognostic Value of Central Nervous System Comorbidities in Patients and their Families
abstract: Central nervous system comorbidities have been identified in patients with epilepsy. Several of these comorbidities have been correlated with poor surgery outcomes in patient cohorts. The authors sought to determine if prevalence of comorbidities in pediatric epilepsy surgery patients and their families correlate with long-term seizure outcome in a cross-sectional analysis. Three-generation pedigrees were elicited to compare family history of epilepsy, ADHD, anxiety, autism, bipolar disorder, cognitive disability, depression, migraine, and motor disability to surgery outcomes in 52 patients. Proportions of affected patients and relatives were compared to general population comorbidity rates and the patients' most recent seizure outcome classification. Patients and families had significantly higher rates of comorbidities than the general population. Poorer long-term seizure outcomes following resective surgery were associated with autism or cognitive disability in patients. Together these data support evidence for a common pathophysiological mechanism between epilepsy and central nervous system comorbidities.
authors.affiliation: 1 Division of Human Genetics, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Krista J
authors.initials: KJ
authors.lastname: Qualmann
authors.affiliation: 1 Division of Human Genetics, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Christine G
authors.initials: CG
authors.lastname: Spaeth
authors.affiliation: 1 Division of Human Genetics, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Melanie F
authors.initials: MF
authors.lastname: Myers
authors.affiliation: 2 Division of Pediatric Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.|3 Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Horn
authors.affiliation: 2 Division of Pediatric Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Holland
authors.affiliation: 4 Division of Pediatric Neurosurgery, Department of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Francesco T
authors.initials: FT
authors.lastname: Mangano
authors.affiliation: 2 Division of Pediatric Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Hansel M
authors.initials: HM
authors.lastname: Greiner
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology*; D008881:Migraine Disorders / Q000453:epidemiology*; D000068079:Motor Disorders / Q000453:epidemiology*; D019635:Neurosurgical Procedures; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
keywords: clinical outcomes; family history; intractable epilepsy; pathophysiological mechanism; resective surgery