Cognitive Progression in Epilepsy

Seidenberg, Michael; Pulsipher, Dalin T.; Hermann, Bruce P.

doi:10.1007/s11065-007-9042-x

Cited by 89 publications

(69 citation statements)

References 55 publications

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“…These changes may reflect a reversal of preoperative VIQ decline. 3,39 A similar pattern has also been reported in adults after left temporal lobe surgery. 40 Overall, intellectual gains observed in surgically treated patients with TLE in our study are striking when viewed in the context of the risk of cognitive deterioration documented over the medium term in conventionally treated patients with early-onset TLE.…”

Section: Figure 3 Longitudinal Profile Of Iq Changessupporting

confidence: 74%

Long-term intellectual outcome after temporal lobe surgery in childhood

Skirrow¹,

Cross²,

Cormack³

et al. 2011

Neurology

213

199

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Objective: Temporal lobe resection is an established treatment for medication-resistant temporal lobe epilepsy, which in recent years has increasingly been performed in children. However, little is known about the long-term outcome in these children. The aim of this study was to characterize intellectual and psychosocial functioning of children after temporal lobe resection as they progress into late adolescence and adulthood. Methods:We report the long-term follow-up of 42 children who underwent temporal lobe surgery after an average postoperative period of 9 years. Longitudinal change in IQ was documented, psychosocial outcome including quality of life was assessed, and preoperative and postoperative T1-weighted MRI brain scans were evaluated quantitatively. A well-matched nonsurgical comparison group of 11 children with similar clinical characteristics was also assessed.Results: At follow-up, 86% of the surgical group were seizure-free, and 57% were no longer taking antiepileptic medication. A significant increase in IQ was found in the surgical group after an extended follow-up period of Ͼ5 years. This IQ change was not found in the nonsurgical comparison group. IQ increases were associated with cessation of antiepileptic medication and changes in MRI-derived gray matter volume. The surgical group also reported better psychosocial outcome including quality of life, which was more strongly associated with seizure freedom rather than surgery per se. Conclusions:Surgery for temporal lobe epilepsy performed in childhood results in excellent long-term seizure control and favorable cognitive outcome along with positive effects on brain development. Classification of evidence:This study provides Class III evidence that temporal lobectomy in children with temporal lobe epilepsy is associated with improved long-term intellectual outcomes compared with those undergoing standard medical treatment. Neurology Medication-resistant temporal lobe epilepsy (TLE) is often caused by brain abnormalities such as tumors or hippocampal sclerosis. Surgical removal of such lesions results in excellent seizure control.1 When surgical treatment for TLE in children is considered, factors such as the impact of seizures and medication on brain development and function have to be taken into account.2 Because children with poor seizure control show a decrease in intellectual functioning over time, 3 it is thought that early surgical intervention could reduce the severity of cognitive impairment.

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Section: Figure 3 Longitudinal Profile Of Iq Changessupporting

confidence: 74%

Long-term intellectual outcome after temporal lobe surgery in childhood

Skirrow¹,

Cross²,

Cormack³

et al. 2011

Neurology

213

199

View full text Add to dashboard Cite

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“…Interictal discharges may produce restlessness, distractibility, inability to focus, decreased capacity for taking in new information and behavioural disturbances (Freeman et al, 1990). Epilepsy can disrupt the way some of the brain cells function, while the frequency of seizures can affect this even more (Seidenberg, Pulsipher, & Hermann, 2007). No one example is characteristic of the experience of all students with epilepsy.…”

Section: Barrier To Learning Created By Neurological Deviationmentioning

confidence: 99%

Canada’s Implementation of the Right to Education for Students with Disabilities

Shah

2010

International Journal of Disability, Development and Education

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“…16 Algumas pesquisas têm sido realizadas com o intuito de caracterizar a extensão e a natureza do comprometimento cognitivo decorrente da epilepsia crônica. Este declínio é evidente em múltiplos domínios cognitivos, 5,6,17 mas parece ser mais intenso e frequente nos domínios da memória verbal, atenção e velocidade psicomotora. 17 A duração da epilepsia parece ser o maior fator preditivo do comprometimento cognitivo.…”

Section: Introductionunclassified

“…Este declínio é evidente em múltiplos domínios cognitivos, 5,6,17 mas parece ser mais intenso e frequente nos domínios da memória verbal, atenção e velocidade psicomotora. 17 A duração da epilepsia parece ser o maior fator preditivo do comprometimento cognitivo. 5,17 Por outro lado, a demência predispõe o paciente a apresentar crises epilépticas como consequência do desenvolvimento de lesões neurológicas, algumas vezes epileptogênicas.…”

Section: Introductionunclassified

“…17 A duração da epilepsia parece ser o maior fator preditivo do comprometimento cognitivo. 5,17 Por outro lado, a demência predispõe o paciente a apresentar crises epilépticas como consequência do desenvolvimento de lesões neurológicas, algumas vezes epileptogênicas. 4,7,9,14 A frequência de epilepsia associada à demência pode variar conforme a etiologia, embora ainda haja poucos dados a este respeito na literatura.…”

Section: Introductionunclassified

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Epilepsia e demência em uma amostra de pacientes idosos acompanhados em serviço terciário

Almeida

Fonseca

Santos

et al. 2009

J. epilepsy clin. neurophysiol.

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RESumo objetivo: Determinar a freqüência de epilepsia em uma amostra ambulatorial de pacientes idosos com demência e analisar possível associação da epilepsia a uma causa específica de demência. metodologia: Estudo retrospectivo com dados de 135 pacientes com demência acompanhados em ambulatório de Neurologia Cognitiva, no período de setembro de 2006 a novembro de 2007. Foi realizado levantamento de dados clínicos, laboratoriais, de neuroimagem e de eletroencefalograma. As etiologias das demências foram definidas de acordo com critérios diagnósticos específicos, a partir do quadro clínico, exame neurológico, avaliação neuropsicológica, exames laboratoriais e de neuroimagem. Resultados: A freqüência de epilepsia foi 12%, sendo maior na demência mista (21,4%), seguida pela demência frontotemporal (18,6%), demência vascular (15,4%) e doença de Alzheimer (10,8%). No entanto, nenhuma diferença estatística foi observada entre essas freqüências (p = 0,817). Observou-se que 87,5% dos pacientes iniciaram o quadro de epilepsia na vida adulta, sendo que em 84,6% destes pacientes, o desenvolvimento de epilepsia foi posterior ao início do declínio cognitivo. Os tipos de crise mais comuns foram a tônico-clônico generalizada (43%) e a parcial complexa (38%). Conclusão: Apesar da freqüência de epilepsia ser variável entre os diversos tipos de demência, essa variabilidade não foi suficiente para demonstrar diferença estatística. unitermos: Epilepsia, demência, idosos. AbSTRACTEpilepsy and dementia in a sample of elderly patients followed at a tertiary outpatient clinic objectives: To determine the frequency of epilepsy in a sample of elderly outpatients with dementia and to evaluate whether epilepsy was more associated with a specific dementia etiology. methodology: Data from 135 patients with dementia were retrospectively analyzed in a Cognitive Neurology Outpatient Unit. We analyzed data from clinical evaluation, neurological examination, neuropsychological testing, laboratory and neuroimaging findings, and electroencephalogram, whenever available. Etiologies of dementia were defined according to specific diagnostic criteria. Results: Epilepsy was present in 12% of the cases, being more frequent in mixed dementia (21.4%), followed by frontotemporal dementia (18.6%), vascular dementia (15.4%) and Alzheimer's disease (10.8%). However, the rates of epilepsy across the different dementia etiologies were not significantly different (p = 0.817). Overall, 87.5% of patients started the epilepsy during adulthood, and in 84.6% of these individuals, epilepsy started after the emergence of cognitive decline. The most common types of seizures were generalized tonic-clonic (43%) and complex partial (38%). Conclusion: Although epilepsy occurred rather commonly in this sample of patients with dementia, no significant difference was found among the distinct etiologies.

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Cognitive Progression in Epilepsy

Cited by 89 publications

References 55 publications

Long-term intellectual outcome after temporal lobe surgery in childhood

Long-term intellectual outcome after temporal lobe surgery in childhood

Canada’s Implementation of the Right to Education for Students with Disabilities

Epilepsia e demência em uma amostra de pacientes idosos acompanhados em serviço terciário

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