NEUROPSYCHOLOGICAL OUTCOME TWO TO FOUR YEARS AFTER EPILEPSY SURGERY IN CHILDREN AND ADOLESCENTS
Abstract number :
1.466
Submission category :
Year :
2003
Submission ID :
3848
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Mary Lou Smith, Irene M. Elliott, Lucyna Lach Psychology, University of Toronto at Mississauga, Mississauga, ON, Canada; Neurology, Hospital for Sick Children, Toronto, ON, Canada; Social Work, McGill University, Montreal, QC, Canada
The purpose of this study was to investigate the neuropsychological outcomes of epilepsy surgery in children and adolescents, using a controlled, prospective design. We have previously reported that children who undergo epilepsy surgery do not differ from controls with intractable epilepsy one year after surgery. In this phase of the research we extended the follow-up period to two to four years after surgery to address the question of whether an advantage in neuropsychological function may emerge over time.
Two groups of children with medically refractory epilepsy were studied at three points in time. The surgical group (n=23) underwent a baseline assessment prior to surgery and at 1 and 2-4 years post-operatively. A comparison group (n=15) was studied at comparable points in time. At baseline, the groups were comparable in age, age at seizure onset, seizure frequency, number of AEDs, sex, handedness and IQ. Intelligence, verbal memory, visual memory, visual sustained attention, and academic skills were examined, using objective, standardized tasks.
Multivariate analyses of variance (with group and time as independent variables) were conducted on four categories of neuropsychological function: intelligence, memory, attention and academic skills. A significant effect was found only for the academic area, and was an effect of time (F(2,210)=6.62, p[lt].002); over time, the standard scores on the academic measures declined for both groups. Within the surgical group, there were no differences in test performance relating to seizure outcome.
In this longitudinal investigation, changes in neuropsychological performance were not found to be associated with either surgical status or seizure outcome. Academic scores declined in both the surgical and the comparison group; findings suggest a slowed rate of acquisition of skills over time relative to the normative population. Benefits of surgery and seizure control are not apparent in these aspects of neuropsychological function within the first 2-4 years after surgery.
[Supported by: The Ontario Mental Health Foundation ]