Abstracts

Rationale: Improved health-related quality of life (HRQOL) is an expected benefit of pediatric epilepsy surgery that likely reflects a combination of factors such as better seizure control, reduced medication effects, and improved cognition and psychosocial functioning. However, the specific factors underlying improvements in post-surgical HRQOL have not been adequately studied in children. In pediatric epilepsy, cognitive factors – specifically developmental delays and attention/executive difficulties – are related to poor HRQOL, and prior studies in adult patients indicate that memory functioning is associated with HRQOL ratings, but post-surgical memory decline does not necessarily translate into reduced HRQOL. The purpose of this study was to investigate the relationship between memory functioning and HRQOL in children who have undergone epilepsy surgery. Methods: The study involved an archival review of neuropsychological assessments of children who underwent epilepsy surgery for intractable seizures at BC Children’s Hospital. Data for 43 children were collected, including delay scores on the Rey Complex Figure Test (RCFT), California Verbal Learning Test, Children’s Version (CVLT-C), and Children’s Memory Scale (CMS) substests of Faces, Family Picture and Stories, along with a parent-rated quality of life scale (Impact of Childhood Illness scale). Results: Changes in quality of life were not significantly related to changes in memory functioning, and mean memory scores were generally unchanged after surgery. However, lower pre-surgical memory functioning as measured by the RCFT was associated with poor post-surgical HRQOL (r = -.46, p < .01), and poor post-surgical scores on the RCFT, CVLT-C, Faces, and Family Pictures were all associated with worse post-surgical HRQOL (r = -.30, -.46, -.35, and -.37, respectively, p < .0001 to < .05).Conclusions: This study adds to increasing evidence that the HRQOL of children with intractable epilepsy is significantly related to cognitive factors. Changes in memory functioning per se do not appear to strongly predict quality of life; rather, it is the presence of memory problems, particularly post-surgically, that are associated with lower HRQOL in pediatric epilepsy surgery patients.