Remembrance and time passed: Memory outcomes 4–11 years after pediatric epilepsy surgery

Puka, Klajdi; Smith, Mary Lou

doi:10.1111/epi.13571

Cited by 14 publications

(19 citation statements)

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“…[19][20][21][22][23] In long-term follow-up (mean postoperative period of 7 years), poorer story recall scores have been documented for children with left TLE compared to those with right TLE. 24 Another study showed that at a mean of 9 years postoperatively, verbal memory outcome was comparable between children who underwent left TLE, right TLE, and children with TLE treated pharmacologically. 23 It is possible that the potential deleterious effects of early surgical intervention are mitigated by greater brain plasticity in childhood.…”

Section: Discussionmentioning

confidence: 99%

“…In children, there have been mixed findings for verbal memory outcome after left temporal lobectomy; declines in memory have been reported in some studies, but not in others . In long‐term follow‐up (mean postoperative period of 7 years), poorer story recall scores have been documented for children with left TLE compared to those with right TLE . Another study showed that at a mean of 9 years postoperatively, verbal memory outcome was comparable between children who underwent left TLE, right TLE, and children with TLE treated pharmacologically .…”

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confidence: 99%

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Verbal memory after temporal lobe epilepsy surgery in children: Do only mesial structures matter?

et al. 2016

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Verbal memory after temporal lobe epilepsy surgery in children: Do only mesial structures matter?

et al. 2016

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“…Within the studies, age at surgery or at presurgical assessment varied from a few months to 18 years. Follow-up after surgery also varied widely, some studies reporting intervals of 4 to 11 years 19,20,22,23 or 0.9 to 15 years, 24 whereas others used fixed intervals of, for example, 2 years. [25][26][27][28] The major aim of most studies was to detect the impact, if any, of epilepsy-related variables on the cognitive outcome measures.…”

Section: Questionsmentioning

confidence: 99%

“…Effects of IQ, DQ, or index (DQ/DI) or a mixture of several approximations of cognitive functioning (among which parental evaluations of their children's adaptive achievements) on targeted cognitive functions were statistically determined in several studies. [19][20][21]25,26,39,44,52 Most of the analyses had an exploratory character without definitive conclusions.…”

Section: Disturbance Of Performances In Tests Of One Function By Defimentioning

confidence: 99%

“…Mutual interference of specific cognitive domains was studied in a few articles, addressing predominantly memory, intelligence, and language. Puka et al 19 , of the Toronto group, studied memory in a group of children who had undergone several types of resection (hemispher/ec/o/tomy cases excluded); they calculated correlations between memory scores and discussed the interrelations between the scores on the examined memory components. They warned that abilities in domains, such as language, attention, executive function, and visual-spatial processing potentially affect memory performance and that the impact of interference from those domains should be considered in future studies.…”

Section: Disturbance Of Performances In Tests Of One Function By Defimentioning

confidence: 99%

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Reflection on Assessing the Development of Children after Epilepsy Surgery

Jennekens‐Schinkel

Schooneveld

2018

J Pediatr Epilepsy

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Children of schoolage having similar medical and neuropsychological conditions but entirely different life courses after left-sided hemispherectomy led us to reflect on sources of differences in development after epilepsy surgery. Two recent reviews exposed the impact of epilepsy-related variables on the cognitive outcomes and concluded that overall the surgical procedures had not caused additional harm. Our aim was to see whether facilitating or impeding influences—other than epilepsy and epilepsy surgery—were addressed in the literature regarding cognitive outcome. Further review of the literature did not yield information on influences of variables that are known to affect normal development; no study addressed influences of motor and/or sensory impairments. Few studies discussed interference of deficits in other cognitive domains with the target domains. The influences of gender and of an important environmental aspect, family factors, etc., were underexposed as well. Understanding why one child adjusts to her/his novel life situation and another child with apparently similar abilities and impairments is unable to do so, is essential for adequate counseling. A more biographical approach of cognitive development is proposed to understand the differential life courses of children and adolescents with a history of epilepsy surgery. A perspective of “functioning” rather than cognitive “functions,” conceived of as independent entities, will help bridge the gap between neurocognitive and more biographical approaches to the functioning of children after epilepsy surgery.

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IQ changes after pediatric epilepsy surgery: a systematic review and meta-analysis

Schmidlechner,

Zaddach,

Heinen

et al. 2023

J Neurol

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Objective This systematic review aimed to assess the intellectual outcome of children who underwent surgery for epilepsy. Methods A systematic review of electronic databases was conducted on December 3, 2021, for PubMed and January 11, 2022, for Web of Science. The review was conducted according to the PRISMA guidelines. The included studies reported on intelligence quotient (IQ) or developmental quotient (DQ) before and after epilepsy surgery in children. Studies were included, if the patients had medically intractable epilepsy and if the study reported mainly on curative surgical procedures. We conducted a random-effects meta-analysis to determine the mean change of IQ/DQ. Results Fifty-seven studies reporting on a total of 2593 patients met the inclusion criteria. The mean age at surgery was 9.2 years (± 3.44; range 2.4 months–19.81 years). Thirty-eight studies showed IQ/DQ improvement on a group level, 8 yielded stable IQ/DQ, and 19 showed deterioration. Pooled analysis revealed a significant mean gain in FSIQ of + 2.52 FSIQ points (95% CI 1.12–3.91). The pooled mean difference in DQ was + 1.47 (95% CI − 6.5 to 9.5). The pooled mean difference in IQ/DQ was 0.73 (95% CI − 4.8 to 6.2). Mean FSIQ gain was significantly higher in patients who reached seizure freedom (+ 5.58 ± 8.27) than in patients who did not (+ 0.23 ± 5.65). It was also significantly higher in patients who stopped ASM after surgery (+ 6.37 ± 3.80) than in patients who did not (+ 2.01 ± 2.41). Controlled studies showed a better outcome in the surgery group compared to the non-surgery group. There was no correlation between FSIQ change and age at surgery, epilepsy duration to surgery, and preoperative FSIQ. Significance The present review indicates that there is a mean gain in FSIQ and DQ in children with medically intractable epilepsy after surgery. The mean gain of 2.52 FSIQ points reflects more likely sustainability of intellectual function rather than improvement after surgery. Seizure-free and ASM-free patients reach higher FSIQ gains. More research is needed to evaluate individual changes after specific surgery types and their effect on long-term follow-up.

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Remembrance and time passed: Memory outcomes 4–11 years after pediatric epilepsy surgery

Abstract: Patients who became seizure-free had some advantages in memory, but did not show improvements over time. These findings have important implications for understanding potential outcomes from surgery or continued use of antiepileptic medications.

Cited by 14 publications

References 37 publications

Verbal memory after temporal lobe epilepsy surgery in children: Do only mesial structures matter?

Verbal memory after temporal lobe epilepsy surgery in children: Do only mesial structures matter?

Reflection on Assessing the Development of Children after Epilepsy Surgery

IQ changes after pediatric epilepsy surgery: a systematic review and meta-analysis

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