Neuropsychological status at seizure onset in children

Fastenau, Philip S.; Johnson, Cynthia S.; Perkins, Susan M.; Byars, Anna W.; deGrauw, Ton J.; Austin, Joan K.; Dunn, David W.

doi:10.1212/wnl.0b013e3181b23551

Cited by 205 publications

(181 citation statements)

References 43 publications

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“…This finding is consistent with the literature that shows that ongoing refractory seizures are associated with poorer cognitive outcome. 5,9,24 In contrast, the patients with short duration of seizures prior to resection had better outcomes, with more postsurgical improvement. These findings argue for earlier resection in the context of lesion-associated seizures to preserve cognitive functions.…”

Section: Discussionmentioning

confidence: 94%

Impact of epilepsy surgery on development of preschool children: identification of a cohort likely to benefit from early intervention

Shurtleff

Barry

Firman

et al. 2015

PED

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OBJECT Outcomes of focal resection in young children with early-onset epilepsy are varied in the literature due to study differences. In this paper, the authors sought to define the effect of focal resection in a small homogeneous sample of children who were otherwise cognitively intact, but who required early surgical treatment. Preservation of and age-appropriate development of intelligence following focal resection was hypothesized. METHODS Cognitive outcome after focal resection was retrospectively reviewed for 15 cognitively intact children who were operated on at the ages of 2–6 years for lesion-related, early-onset epilepsy. Intelligence was tested prior to and after surgery. Effect sizes and confidence intervals for means and standard deviations were used to infer changes and differences in intelligence between 1) groups (pre vs post), 2) left versus right hemisphere resections, and 3) short versus long duration of seizures prior to resection. RESULTS No group changes from baseline occurred in Full Scale, verbal, or nonverbal IQ. No change from baseline intelligence occurred in children who underwent left or right hemisphere surgery, including no group effect on verbal scores following surgery in the dominant hemisphere. Patients with seizure durations of less than 6 months prior to resection showed improvement from their presurgical baseline in contrast to those with seizure duration of greater than 6 months prior to surgery, particularly in Wechsler Full Scale IQ and nonverbal intelligence. CONCLUSIONS This study suggests that surgical treatment of focal seizures in cognitively intact preschool children is likely to result in seizure remediation, antiepileptic drug discontinuation, and no significant decrement in intelligence. The latter finding is particularly significant in light of the longstanding concern associated with performing resections in the language-dominant hemisphere. Importantly, shorter seizure duration prior to resection can result in improved cognitive outcome, suggesting that surgery for this population should occur sooner to help improve intelligence outcomes.

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Section: Discussionmentioning

confidence: 94%

Impact of epilepsy surgery on development of preschool children: identification of a cohort likely to benefit from early intervention

Shurtleff

Barry

Firman

et al. 2015

PED

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“…The other investigators explained that the cognitive impairment could be attributed to brain damage, age of onset of epilepsy, nature and location of seizure focus, duration of epilepsy, anticonvulsant drugs and epilepsy related surgery 5,6,7,8 Few earlier studies reported that there is significant cognitive impairment in patients with idiopathic GTCS without brain damage. 10,11 The cognitive impairment could be due to subtle brain damage which the present investigators could not exclude with neurological and neuropsychological investigations. The apparent cognitive impairment could be the result of impairment in concentration (BCRS).…”

Section: Discussionmentioning

confidence: 72%

“…37,38 Childhood onset absence epilepsy had subtle cognitive deficits and duration of illness, seizure frequency, antiepileptic drug treatment were related to the severity of the cognitive deficits. 11,39 Patients with idiopathic occipital lobe epilepsy scored worse than controls in intellectual functioning, memory, and attention. 40 Deficits in motor skills, response inhibition, attention, working memory, planning, and psychomotor speed were noted in patients with Temporal lobe epilepsy.…”

Section: Introductionmentioning

confidence: 99%

“…5,6,7,8 Other studies have focused on cognitive performance at disease onset and found that individuals with epilepsy performed worse than siblings or normal controls on several neuropsychological tests. 9,10,11,12 The domains of cognition most often affected include attention and concentration, language, memory, intelligence, executive functions, motor speed and visuo-spatial processing speed. 13,14 Patients with epilepsy showed impaired sustained attention on vigilance tasks.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cognitive Impairment in Epilepsy: A Clinical Study

A¹,

Mathai²

2017

IOSR JDMS

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“…Children with new-onset seizures or new-onset epilepsy are known to have neuropsychological deficits and academic underachievement, [23][24][25][26] even when they are intellectually healthy. It is possible that there is an antecedent neurobiologic alteration that predisposes to both seizures and neuropsychological deficits.…”

mentioning

confidence: 99%