Neuropsychological results in pediatric patients with epilepsy surgery in the parietal cortex

Abstract

SUMMARYThis study evaluated pre-and postoperatively cognitive functions in 15 pediatric patients with surgically treated parietal lobe epilepsy (PLE). Seizure outcome was very satisfying with 87% seizurefree patients 1 year after surgery, and 82% in the long-term follow-up. Preoperative intelligence was in the subaverage range. Impairments in specific cognitive functions (memory, attention, executive functions) were evident preoperatively for 39-66% of patients. Behavioral disorders were rare. No side differences (left versus right PLE) were indicated pre-or postoperatively. Postoperative improvements were found in behavior and attention; other cognitive functions were unchanged. All in all, this preliminary study indicated a satisfactory neuropsychological outcome in pediatric patients with PLE. KEY WORDS: Children, Epilepsy surgery, Neuropsychology, Parietal lobe epilepsy.The parietal lobes (PLs) account for approximately 25% of brain volume, but partial seizures of PL origin account for only 5% of all partial epilepsies (Rasmussen, 1987). Accurately localizing parietal lobe epilepsy (PLE) is often difficult because of its inconsistent semiologic features. Seizures in many parts of the PLs are functionally silent and may only appear after having spread to adjacent brain regions such as the post-or precentral gyrus or temporal lobe. Brain tumors are the most common cause of PLE (Salanova et al., 1995) and surgical treatment is frequently successful. However, the PLs contain highly eloquent areas and resection may lead to deficits in vision, language, praxis, attention, and higher cortical functions. The PL plays a crucial role in linking sensation to action. Lesion studies show that a wide range of sensorimotor functions can be disrupted in patients with PL damage including visual or tactile agnosia, apraxia, acalculia, agraphia, aphasia, impaired cross-modal matching, rightleft disorientation, contralateral neglect, and disorders of body image (Siegel, 2003). Very few studies evaluate neuropsychological patterns associated with PLE and

Cognitive development from two to ten years after pediatric epilepsy surgery

“…Stable or small changes in IQ after epilepsy surgery have been reported in short-term and long-term follow-up studies [18,[26][27][28][29][30]. Cognitive stability between two and ten years was reported after temporal lobe surgery in adults [31].…”

“…Improved general attention was found one year after surgery in children by Gleissner [3,29]. We assessed attention as sustained attention, attention span, impulse control and reaction times and found an increased ability to sustain attention over time and improved impulse control.…”

Cognitive Disorders Associated with Epilepsy: Diagnosis and Treatment

“…They have also found deficits in specific cognitive functions such as memory, attention and executive functions, in a large percentage of patients. 34 It was also demonstrated that, depending on the lateralization of the epilepsy, some functions can be more affected than others. In PLE of the dominant hemisphere for language, we can find deficits in auditory-verbal memory, language (logic and grammar), problem-solving (eg, Raven's matrices) and attention tests.…”

“…On the other hand, in patients with PLE of the non-dominant hemisphere, poorer results are found in visual memory tests and tests related to imagination and visuospatial orientation. 34 …”

Symptomatic and presumed symptomatic focal epilepsies in childhood: An observational, prospective multicentre study

“…[26][27][28][29][30][31][32][33][34] Previous studies, mostly retrospective, revealed that children with drug-resistant focal epilepsy score lower on IQ tests, and in particular regarding to memory. [26][27][28][29][30][31][32][33][34] Previous studies, mostly retrospective, revealed that children with drug-resistant focal epilepsy score lower on IQ tests, and in particular regarding to memory.…”