Cognitive outcome after extratemporal epilepsy surgery in childhood

Authors

  • Luigi D’Argenzio,

    1. Neuroscience Department, UCL Institute of Child Health & Great Ormond Street Hospital NHS Trust, London, United Kingdom
    2. National Centre for Young People with Epilepsy, Lingfield, United Kingdom
    Search for more papers by this author
  • Maria Chiara Colonnelli,

    1. Neuroscience Department, UCL Institute of Child Health & Great Ormond Street Hospital NHS Trust, London, United Kingdom
    2. National Centre for Young People with Epilepsy, Lingfield, United Kingdom
    Search for more papers by this author
  • Sue Harrison,

    1. Neuroscience Department, UCL Institute of Child Health & Great Ormond Street Hospital NHS Trust, London, United Kingdom
    Search for more papers by this author
  • Thomas S. Jacques,

    1. Neural Development Unit, Department of Histopathology, UCL Institute of Child Health & Great Ormond Street Hospital NHS Trust, London, United Kingdom
    Search for more papers by this author
  • William Harkness,

    1. Neuroscience Department, UCL Institute of Child Health & Great Ormond Street Hospital NHS Trust, London, United Kingdom
    Search for more papers by this author
  • Faraneh Vargha-Khadem,

    1. Developmental Cognitive Neuroscience Unit, UCL Institute of Child Health & Great Ormond Street Hospital NHS Trust, London, United Kingdom
    Search for more papers by this author
  • Rod C. Scott,

    1. Neuroscience Department, UCL Institute of Child Health & Great Ormond Street Hospital NHS Trust, London, United Kingdom
    2. National Centre for Young People with Epilepsy, Lingfield, United Kingdom
    Search for more papers by this author
  • J. Helen Cross

    1. Neuroscience Department, UCL Institute of Child Health & Great Ormond Street Hospital NHS Trust, London, United Kingdom
    2. National Centre for Young People with Epilepsy, Lingfield, United Kingdom
    Search for more papers by this author

Address correspondence to Luigi D’Argenzio, Neurosciences Department, UCL Institute of Child Health, 4/5 Long Yard, London WC1 3LU, U.K. E-mail: l.d’argenzio@ucl.ac.uk

Summary

Purpose:  The present study aims to describe the cognitive profile of children with medically refractory extratemporal epilepsies who undergo focal surgery and to identify determinants for preoperative and postoperative cognitive level.

Methods:  This is a retrospective cohort study. Children who underwent operations between 1997 and 2008 with a focal lesion in frontal, parietal, or occipital cortices and with a presurgical or postsurgical cognitive evaluation, were eligible for the study.

Key Findings:  Sixty-six children (53% male) with a mean age of 9.3 ± 8.8 years were enrolled. The overall full-scale IQ (FSIQ) at cognitive testing was 77.4 ± 44.4 before surgery. Children did not show any significant change in their FSIQ after surgery. Duration of presurgical epilepsy, age at epilepsy onset, etiology, and gender were found to be independently associated with lower FSIQ before surgery. Presurgical cognitive level was the only factor independently associated with postsurgical FSIQ. Overall, 51.5% of children who underwent surgery were seizure-free; however, the good postsurgical epilepsy control did not seem to influence the cognitive outcome.

Significance:  Children with extratemporal lobe epilepsy are below the normal cognitive level range. Intellectual abilities of children undergoing surgery are determined independently by presurgical factors and surgery does not seem to affect the cognitive level in the postsurgical period, even for those who become free from clinical seizures.

Ancillary