Abstracts

Specific difficulties in cognitive functioning, including intelligence, memory and executive functioning, may be apparent after surgery for intractable epilepsy in adulthood. Moreover, cognitive functioning more generally has been related to quality of life in adults. However, there is very limited information on the long-term neurocognitive outcomes for adults who had epilepsy surgery as children. The purpose of the study was to examine the cognitive status of young adults who, as children, had undergone epilepsy surgery and to relate this to their cognitive status as children. Thirty-four individuals, aged 20 to 29, who had undergone pediatric epilepsy surgery participated in the study: 21 were seizure-free while 13 continued to have seizures. Sixteen young adults with childhood epilepsy and ongoing seizures, who had not undergone surgery, served as a comparison group. All participants completed a neuropsychological assessment consisting of brief measures of intelligence (WAIS III Vocabulary, Block Design), memory (WMS III Logical Memory, Memory for Faces) and executive functioning (Wisconsin Card Sort). There were no differences between groups in the age at seizure onset (F[lt]1.0) or between the surgical groups in the age at surgery (F[lt]1.0). Analysis of variance comparing the three groups as young adults indicated poorer performance on measures of verbal and nonverbal intellectual functioning, and poorer verbal memory, in the surgical group with seizures relative to the seizure-free surgical group as well as the control group (p[apos]s [lt] .05). However, separate analyses of variance indicated that, relative to performance pre- and post-surgery in childhood, no differences were noted within each of the surgical groups (all p[apos]s [gt] .05) at follow-up assessment. The results of this study indicated that for young adults who underwent epilepsy surgery in childhood, cognitive outcome remained unchanged relative to childhood levels of functioning. These findings represent a significant contribution to our understanding of the long-term outcome of childhood epilepsy surgery. Previous studies have shown no cognitive change after relatively short follow-up, and these findings suggest that restitution, reorganization or enhanced development does not occur after surgery. (Supported by Ontario Mental Health Foundation.)