Visual cognitive function in infants with intractable epilepsy before and after surgery
Tsukasa Ohashi1, Iwao Kobayashi, Hirokata Ooe
1Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi-cho, Kodaira, Tokyo 187 8551, Japan.
Insights
Evaluating visual cognitive function in infants with epilepsy after surgery is crucial. Specific tests can detect subtle cognitive improvements in children with severe developmental delays following epilepsy surgery.
Area of Science:
- Pediatric Neurology
- Developmental Neuroscience
- Ophthalmology
Background:
- Pediatric epilepsy surgery aims to enhance psychomotor development.
- Limited methods exist for assessing cognitive function in infants with severe developmental delays.
Purpose of the Study:
- To evaluate the visual cognitive function of infants undergoing surgery for intractable epilepsy.
- To identify suitable assessment tools for this population.
Main Methods:
- A battery of tests was administered to eight patients pre- and post-surgery.
- Tests included the Erhardt Developmental Vision Assessment (EDVA), ocular pursuit, visual acuity tests, and existing developmental tests.
Main Results:
- EDVA and ocular pursuit scores correlated with developmental age, similar to existing developmental tests.
- Some patients showed significant improvements in EDVA and ocular pursuit scores, despite minimal changes in overall developmental age.
Conclusions:
- The evaluated tests are appropriate for assessing infants with intractable epilepsy and severe developmental delay.
- These assessments can detect early cognitive changes post-surgery in this vulnerable group.
Purpose:
One purpose of pediatric epilepsy surgery is to improve psychomotor development. However, few methods are available for evaluating cognitive function in infants with severe developmental delays. We used the following battery of tests to evaluate visual cognitive function of infants following surgery for intractable epilepsy.
Methods:
The following battery of tests were used to evaluate eight patients before and 1 month after surgery: (1) Erhardt Developmental Vision Assessment (EDVA); (2) evaluation of ocular pursuit for a flashing LED toy; (3) three visual acuity tests preferential looking procedure, optokinetic nystagmus, and Sheridan's Test for Young Children and Retarded balls vision test; and (4) existing developmental test.
Results:
EDVA scores and ocular pursuit score with a flashing LED toy showed the same trends with developmental age as the existing developmental tests. However, in some patients, the EDVA score and ocular pursuit score improved greatly, whereas the developmental age changed very little.
Conclusions:
These tests are suitable for patients with intractable epilepsy and severe developmental delay. By performing these tests before and after surgery, small cognitive changes occurring soon after the surgery may be detected.
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