Cognition and behavior after temporal lobectomy in pediatric patients with intractable epilepsy

Williams, Jane; Griebel, May L.; Sharp, Gregory B.; Boop, Frederick A.

doi:10.1016/s0887-8994(98)00053-8

Cited by 76 publications

(83 citation statements)

References 16 publications

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“…6,10,11,23 IQ changes in this cohort were only seen 6 or more years after surgery, similar to findings in other cohorts. 11,24 In comparison, the fact that studies with shorter duration of follow-up typically do not find improvements in intellectual functioning 5,[25][26][27][28] suggests that a prolonged period is required for cognitive recovery and subsequent development.…”

Section: Predictors Of Fsiq Changementioning

confidence: 99%

“…4 Short-term intellectual outcome in children after temporal lobe surgery is relatively well documented. Although many follow-up studies span up to 2 years after surgery, showing little or no group changes in IQ, [5][6][7][8] long-term follow-up studies commonly extrapolate outcome from only a few individuals because of considerable within-study variation in follow-up duration, [9][10][11] ranging from 6 months to 10 years. Previous studies have suggested that seizure frequency, 12 memory function, 13 and intelligence 11 may show late changes after temporal lobe surgery.…”

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confidence: 99%

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Long-term intellectual outcome after temporal lobe surgery in childhood

Skirrow¹,

Cross²,

Cormack³

et al. 2011

Neurology

216

199

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Objective: Temporal lobe resection is an established treatment for medication-resistant temporal lobe epilepsy, which in recent years has increasingly been performed in children. However, little is known about the long-term outcome in these children. The aim of this study was to characterize intellectual and psychosocial functioning of children after temporal lobe resection as they progress into late adolescence and adulthood. Methods:We report the long-term follow-up of 42 children who underwent temporal lobe surgery after an average postoperative period of 9 years. Longitudinal change in IQ was documented, psychosocial outcome including quality of life was assessed, and preoperative and postoperative T1-weighted MRI brain scans were evaluated quantitatively. A well-matched nonsurgical comparison group of 11 children with similar clinical characteristics was also assessed.Results: At follow-up, 86% of the surgical group were seizure-free, and 57% were no longer taking antiepileptic medication. A significant increase in IQ was found in the surgical group after an extended follow-up period of Ͼ5 years. This IQ change was not found in the nonsurgical comparison group. IQ increases were associated with cessation of antiepileptic medication and changes in MRI-derived gray matter volume. The surgical group also reported better psychosocial outcome including quality of life, which was more strongly associated with seizure freedom rather than surgery per se. Conclusions:Surgery for temporal lobe epilepsy performed in childhood results in excellent long-term seizure control and favorable cognitive outcome along with positive effects on brain development. Classification of evidence:This study provides Class III evidence that temporal lobectomy in children with temporal lobe epilepsy is associated with improved long-term intellectual outcomes compared with those undergoing standard medical treatment. Neurology Medication-resistant temporal lobe epilepsy (TLE) is often caused by brain abnormalities such as tumors or hippocampal sclerosis. Surgical removal of such lesions results in excellent seizure control.1 When surgical treatment for TLE in children is considered, factors such as the impact of seizures and medication on brain development and function have to be taken into account.2 Because children with poor seizure control show a decrease in intellectual functioning over time, 3 it is thought that early surgical intervention could reduce the severity of cognitive impairment.

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Section: Predictors Of Fsiq Changementioning

confidence: 99%

mentioning

confidence: 99%

Long-term intellectual outcome after temporal lobe surgery in childhood

Skirrow¹,

Cross²,

Cormack³

et al. 2011

Neurology

216

199

View full text Add to dashboard Cite

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“…Two studies related a significant effect of the side of surgery on visual memory performance (28)(29) . Other authors found neither neuropsychological decline after surgery nor differences between right or left resection in children (11,23,(29)(30) . Lendt et al (1999) reported significant improvement both in language and attention performance after temporal resection, but no change in memory (11) .…”

Section: Post-surgical Studiesmentioning

confidence: 90%

“…Thus, the dissociation between visual and verbal memory changes during a lifetime, with language becoming progressively more involved in memory storage (16) . Other studies did not find deficits in specific memory (11,(20)(21)(22)(23)(24) . Lendt et al (1999) assessed memory, attention, language and praxis in 20 children (aged 10 and 16 years) before and after temporal lobe resection.…”

mentioning

confidence: 87%

“…Different results on the outcome of memory after temporal lobe surgery in children have been reported, some findings showing memory decline (12,21,23,(26)(27) and other data showing no significant change (11,(29)(30)(31)(32)(33) . The discrepancy may be due to the fact that TLE in childhood is a different condition from TLE in adults, both in terms of clinical features and neuropathology (34) .…”

Section: Post-surgical Studiesmentioning

confidence: 98%

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Memory impairment in children with temporal lobe epilepsy: a review

Guimarães

Rzezak

et al. 2006

J. epilepsy clin. neurophysiol.

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Introduction:The authors present a review article on memory aspects of temporal lobe epilepsy in childhood. Methods: We performed a search in the literature. Results: Temporal lobe epilepsy (TLE) in childhood present with great clinical, electroencephalographic and etiological diversity. The neuropsychological features in children with TLE are not well-defined yet. The relationship between the lateralization of the lesion and performance on memory tests is not established. Conclusion: The studies performed in children with TLE show controversy data. This finding may be due to the etiological, clinical and electroencephalographic diversity seen in such group of children. Besides, most studies use different assessments. Therefore, it is clear that more studies are necessary to elucidate which neuropsychological deficits occur in children with TLE.

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Noun Verb Dissociation in Parkinson's Disease

Bertella

Albani

Greco

et al. 2002

Brain and Cognition

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The particular problem of recognition from unusual viewpoints, may well involve a substantial problem-solving component and employ frontal/central executive resources. The present study investigates this question using a dual-task technique. In Experiment 1, the reliability of an unusual views effect was demonstrated. Experiment 2 showed that a central executive secondary task selectively disrupts unusual views recognition. These results are discussed in the context of existing lesion and functional imaging findings.

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Cognition and behavior after temporal lobectomy in pediatric patients with intractable epilepsy

Cited by 76 publications

References 16 publications

Long-term intellectual outcome after temporal lobe surgery in childhood

Long-term intellectual outcome after temporal lobe surgery in childhood

Memory impairment in children with temporal lobe epilepsy: a review

Noun Verb Dissociation in Parkinson's Disease

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