Developmental Outcome After Epilepsy Surgery in Infancy

Abstract

After surgery, seizure frequency and developmental quotient improved. Developmental status before surgery predicted developmental function after surgery. Patients who were operated on at younger age and with epileptic spasms showed the largest increase in developmental quotient after surgery.

Longer duration of epilepsy and earlier age at epilepsy onset correlate with impaired cognitive development in infancy

“…However, none of these studies have evaluated the effect of epilepsy in terms of duration and seizure burden on cognition during infancy. The current study expands our previous results on neuropsychological outcome in infants [11] and [15].…”

“…Few available reports have evaluated the intellectual outcome in infants who have undergone epilepsy surgery [4], [11], [13] and [14]. According to results presented by Daniel et al, neuropsychological performance after surgery was best for children who underwent surgery at a younger age.…”

“…Seizures were classified according to the semiological seizure classification [17]. A developmental quotient was calculated for each case (DQ = Bayley Scales of Infant Development mental age divided by subject's biological age) as previously described [11]. Charts were reviewed retrospectively for DQ testing, age at epilepsy onset, duration of epilepsy, seizure frequency, types of seizures (with/without spasms), and etiology of seizures (with/without malformations of cortical development [MCD]).…”

“…The limited evidence that does exist in this age group is derived from longitudinal studies assessing postinterventional neuropsychological outcome in infants with West syndrome [4], [5], [6], [7], [8], [9], [10], [11], [12] and [13] and other epilepsies [5], [6], [7], [10], [11] and [14] (Table 1). Most of these studies have suggested that earlier surgical or medical therapy during infancy may provide higher benefit for intellectual development of children.…”

“…Most of these studies have suggested that earlier surgical or medical therapy during infancy may provide higher benefit for intellectual development of children. Seizure freedom may be associated with better mental development [4], [10], [11], [12], [13] and [14]. However, none of these studies have evaluated the effect of epilepsy in terms of duration and seizure burden on cognition during infancy.…”