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Electromagnetic Source Imaging in Presurgical Evaluation of Children with Drug-Resistant Epilepsy
Published on: September 20, 2024
Cognitive assessment in epilepsy surgery of children
D Battaglia1, D Chieffo, D Lettori
1Child Neuropsychiatry, Catholic University, Rome, Italy. mbattagliad@tiscali.it
Insights
Early epilepsy surgery in children can improve seizures and behavior, with most patients maintaining their neurocognitive level. Further multicentric studies are needed for standardized assessments in young children.
Area of Science:
- Pediatric Neurology
- Developmental Neuroscience
- Epileptology
Background:
- Neurocognitive assessment is crucial before and after surgery in children, but data on pediatric pre- and postoperative evaluations are scarce.
- Limited literature exists on the neuropsychological outcomes of pediatric epilepsy surgery.
Purpose of the Study:
- To examine developmental aspects of neurocognitive assessment in children.
- To review literature on the neuropsychological outcomes of epileptic children undergoing focal resection and hemispherectomy.
Main Methods:
- Review of existing literature on pediatric neurocognitive assessment and epilepsy surgery outcomes.
- Analysis of a cohort of 45 children with refractory epilepsy operated on before age 7.
Main Results:
- Early surgical treatment for refractory epilepsy in children is effective for seizure control and behavioral improvement.
- The majority of pediatric patients in the cohort showed no significant change in their neurocognitive level post-surgery.
- Focal resection and hemispherectomy outcomes in epileptic children were analyzed based on literature data.
Conclusions:
- Early surgical intervention for refractory epilepsy in young children can be beneficial for seizure control and behavior.
- Neurocognitive levels are generally preserved in most children undergoing epilepsy surgery.
- Standardized, multicentric studies are essential for robust neuropsychological assessments in large pediatric cohorts.
Introduction:
Although the neurocognitive assessment in children as in the adults is an important step before and after surgery, in the literature, the data about pre- and postoperative neurocognitive evaluations in children are very few.
Objective:
The purpose of this paper is to consider some peculiar aspects of the neurocognitive assessment during development, and report literature data about neuropsychological outcome of epileptic children treated with focal resection and hemispherectomy.
Results And Discussion:
The second section concerns our personal experience about a cohort of 45 children with refractory epilepsy operated on before 7 years. The results suggest that early surgical treatment is generally effective for seizure control and behavior improvement in children with refractory epilepsy. Concerning cognitive outcome, we found that the neurocognitive level was unchanged in the majority of the patients.
Conclusion:
We underline the importance of multicentric studies with standardized neuropsychological assessments in large series of young children.
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