Academic attainment following pediatric epilepsy surgery: A systematic review

Sherlock, Clara; Madigan, Cathy; Linehan, Christine; Keenan, Lisa; Downes, Michelle

doi:10.1016/j.yebeh.2022.108847

Cited by 3 publications

(4 citation statements)

References 77 publications

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“…37 These deficits typically do not affect daily living independence or the ability to obtain a regular school degree. 38 Similar to the findings of Reinholdson et al, 18 we observed no effect of seizure freedom on academic achievement. As stated above, no leap of cognitive abilities or academic skills should be expected from epilepsy surgery.…”

Section: Academic Attainmentsupporting

confidence: 90%

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How are they doing as adults? Psychosocial and socioeconomic outcomes 11‐30 years after pediatric epilepsy surgery

et al. 2023

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ObjectivePediatric epilepsy surgery yields cure from epilepsy or complete seizure control with continued medication in many patients early in life. This study aimed to evaluate the long‐term (>10 years) psychosocial and socioeconomic outcomes of pediatric epilepsy surgery and examine the role of comorbid disability, type of surgery, seizure freedom, and age at surgery.MethodsA novel ad hoc parent/patient questionnaire was used to assess educational and occupational attainment, marital/familial status, mobility, and other outcomes in patients who underwent unilobar or multilobar surgery for drug‐refractory epilepsy during their childhood. The questionnaire also captured information on comorbid disability.ResultsOf the 353 eligible patients, 203 could still be contacted and 101 of these (50%) returned appropriately filled‐in questionnaires (follow‐up intervals: 11‐30 [mean: 19.6] years). The cure from epilepsy rate was 53%. Type of surgery was strongly confounded by comorbid disability. Patients with comorbid disabilities had significantly lower rates of regular school degrees, gainful employment, marriage, and driving license (N = 29; 12%, 4%, 0%, 3%) compared with non‐disabled patients (N = 69; 89%, 80%, 43%, and 67%, respectively). Patients achieved lower school degrees than their siblings and parents. Non‐disabled seizure‐free patients had better employment and mobility outcomes compared with non‐seizure‐free patients. Age at surgery (<10 vs. ≥10 years of age) did not have any effect on any outcome in patients with preschool seizure onset.SignificancePediatric epilepsy surgery can lead to permanent relief from epilepsy in many patients, but comorbid disability strongly impacts adult life achievement. In non‐disabled patients, favorable outcomes in academic, occupational, marital, and mobility domains were achieved, approaching respective rates in the German population. Complete seizure freedom had additional positive effects on employment and mobility in this group. However, in case of chronic comorbid disability the overall life prospects may be limited despite favorable seizure outcomes.

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Section: Academic Attainmentsupporting

confidence: 90%

“…Focal neurocognitive deficits, such as declarative and working memory disorders, might explain the impact on learning and academic skills 37 . These deficits typically do not affect daily living independence or the ability to obtain a regular school degree 38 …”

Section: Discussionmentioning

confidence: 99%

How are they doing as adults? Psychosocial and socioeconomic outcomes 11‐30 years after pediatric epilepsy surgery

et al. 2023

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“…4 This impairment significantly impacts functional, educational, and vocational outcomes and the quality of life of children and their families. [4][5][6][7][8] Epilepsy surgery is the only therapeutic option that can achieve a cure for children with pharmacoresistant 9 focal lesional epilepsy. 10 In addition to the primary aim of seizure freedom, a key secondary aim of surgery is to stabilize and potentially optimize developmental trajectories.…”

Section: Introductionmentioning

confidence: 99%

“…Uncontrolled seizures can cause potentially irreversible damage to the developing brain, thus impairing the neurodevelopmental trajectory of affected children, 3 by potential slowing, arrest, or even loss of already acquired functions. 4 This impairment significantly impacts functional, educational, and vocational outcomes and the quality of life of children and their families 4–8 …”

Section: Introductionmentioning

confidence: 99%

Long‐term intellectual and developmental outcomes after pediatric epilepsy surgery: A systematic review and meta‐analysis

Stefanos‐Yakoub,

Wingeier,

Held

et al. 2023

Epilepsia

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In addition to the primary aim of seizure freedom, a key secondary aim of pediatric epilepsy surgery is to stabilize and, potentially, optimize cognitive development. Although the efficacy of surgical treatment for seizure control has been established, the long‐term intellectual and developmental trajectories are yet to be delineated. We conducted a systematic review and meta‐analysis of studies reporting pre‐ and postsurgical intelligence or developmental quotients (IQ/DQ) of children with focal lesional epilepsy aged ≤18 years at epilepsy surgery and assessed at >2 years after surgery. We determined the IQ/DQ change and conducted a random‐effects meta‐analysis and meta‐regression to assess its determinants. We included 15 studies reporting on 341 patients. The weighted mean age at surgery was 7.1 years (range = .3–13.8). The weighted mean postsurgical follow‐up duration was 5.6 years (range = 2.7–12.8). The overall estimate of the mean presurgical IQ/DQ was 60 (95% confidence interval [CI] = 47–73), the postsurgical IQ/DQ was 61 (95% CI = 48–73), and the change was +.94 IQ/DQ (95% CI = −1.70 to 3.58, p = .486). Children with presurgical IQ/DQ ≥ 70 showed a tendency for higher gains than those with presurgical IQ/DQ < 70 (p = .059). Higher gains were determined by cessation of antiseizure medication (ASM; p = .041), not just seizure freedom. Our findings indicate, on average, stabilization of intellectual and developmental functioning at long‐term follow‐up after epilepsy surgery. Once seizure freedom has been achieved, ASM cessation enables the optimization of intellectual and developmental trajectories in affected children.

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Medication compliance of children with epilepsy: a cross-sectional survey

Wang,

Zhang,

Wang

et al. 2023

Ital J Pediatr

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Background Good medication compliance is very important for the prognosis of children with epilepsy. We aimed to evaluate the status and influencing factors of medication compliance in children with epilepsy and to provide insights to the clinical nursing care of children with epilepsy. Methods We selected epileptic children admitted to Children’s Hospital of Nanjing Medical University from February 1, 2022 to August 31, 2022. Self-designed questionnaire and medication compliance scale were used to evaluate the characteristics and medication compliance of children with epilepsy. Pearson correlation analysis and multivariate logistic regression were used to analyze the influencing factors of medication compliance. Results A total of 156 children with epilepsy were included, the incidence of poor compliance in children with epilepsy was 37.18%. Pearson correlation analysis indicated that age(r = 0.622), courses of epilepsy(r = 0.553), parental education level(r = 0.506), monthly household income(r = 0.652) and number of drugs taken(r = 0.577) were correlated with the compliance(all P<0.05). Logistic regression analyses indicated that age ≤ 6 y(OR = 2.104, 95%CI: 1.712 ~ 2.527), courses of epilepsy ≤ 3 years(OR = 2.661, 95%CI: 2.089 ~ 2.941), low parental education level(OR = 1.977, 95%CI: 1.314 ~ 2.351), monthly household income ≤ 5000 RMB(OR = 2.812, 95%CI: 2.194 ~ 3.181), number of drugs taken ≥ 3(OR = 3.025, 95%CI: 2.336 ~ 3.475) were the influencing factors of medication compliance in children with epilepsy(all P<0.05). Conclusions The medication compliance of children with epilepsy needs to be improved, and the medication compliance of children is affected by age, courses of epilepsy, parental education level, monthly household income and number of drugs taken. Clinical medical personnel take targeted nursing measures against these factors to improve the medication compliance of children with epilepsy.

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Academic attainment following pediatric epilepsy surgery: A systematic review

Cited by 3 publications

References 77 publications

How are they doing as adults? Psychosocial and socioeconomic outcomes 11‐30 years after pediatric epilepsy surgery

How are they doing as adults? Psychosocial and socioeconomic outcomes 11‐30 years after pediatric epilepsy surgery

Long‐term intellectual and developmental outcomes after pediatric epilepsy surgery: A systematic review and meta‐analysis

Medication compliance of children with epilepsy: a cross-sectional survey

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