Abstracts

RATIONALE: To examine the incidence and impact of developmental disability in children undergoing epilepsy surgery. METHODS: We retrospectively reviewed all surgical cases performed for intractable epilepsy on children under 21 years of age at Miami Children's Hospital between 1995-99. Patients were classified based on the presence or absence of either significant mental retardation (MR) or motor handicap. The two groups were compared with respect to age at onset of seizures, age at surgery, size of resection, post-surgical outcome and etiology. RESULTS:_Of 132 children, 74 (56%) were significantly disabled: 35 (47%) MR alone, 10 (14%) motor handicap alone and 29 (38%) both. Those with disabilities were significantly younger at the onset of seizures (mean 1.4 yrs, median 6 months v. mean 4.3 years, median 3.5 years, significant at p <0.001) and at surgery (7.1 v. 9.9 years, p < 0.005) and were much more likely to have multilobar resections (52% v 9%). Seizure free outcomes with minimum 1 year follow up were comparable (58% v. 67%). Most frequent etiologies confirmed by pathology are presented below. CONCLUSIONS: The developmentally disabled represent a significant proportion of children undergoing epilepsy surgery. In contrast to those without disabilities, the majority had seizure onset within the first year of life and underwent multilobar resections. The presence of disabilities was independent of etiology, either developmental or acquired, with the exception of developmental tumors which were strongly correlated with near normal development.