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Updated: Aug 6, 2025
Author Spotlight: Advancing Pediatric Epilepsy Surgery in Children Through Novel Biomarkers and Enhanced Localization
Published on: September 20, 2024
Characterization and Prediction of Short-term Outcomes in Memory After Temporal Lobe Resection in Children With
Navkiranjot Kaur1, Amy S Nowacki1, Deepak K Lachhwani1
1From the Cleveland Clinic Lerner College of Medicine (N.K., A.S.N., R.M.B.), Case Western Reserve University; Quantitative Health Sciences (A.S.N.), Lerner Research Institute, Cleveland Clinic; Epilepsy Center (D.K.L., W.B., R.M.B.), Neurological Institute, Cleveland Clinic, OH; Division of Pediatric Neuropsychology (M.M.B.), Childrens National Medical Center, Washington, DC; Department of Neurology (M.J.H.), Columbia University Medical Center, New York, NY; and Department of Psychiatry & Psychology (P.K., R.M.B.), and Department of Neurology (P.K., R.M.B.), Neurological Institute, Cleveland Clinic, OH.
Most children (54-69%) showed no significant memory change after temporal lobe epilepsy surgery. Prediction models for memory decline in children are now available for clinical use.
Area of Science:
- Neuroscience
- Pediatric Epilepsy Surgery
- Cognitive Outcomes
Background:
- Episodic memory outcomes after temporal lobe resection in children with epilepsy are not well-characterized.
- Empirical methods for assessing cognitive change are needed to evaluate these outcomes.
- Predictive models for postoperative memory decline can aid clinical decision-making.
Purpose of the Study:
- To characterize short-term episodic memory outcomes after temporal lobe resection in children with epilepsy.
- To develop and internally validate models for predicting postoperative memory decline.
- To provide clinically applicable tools for risk assessment.
Main Methods:
- Retrospective cohort study of 126 children (aged 6-16) undergoing temporal lobe epilepsy surgery.
- Assessment of episodic memory using the Children's Memory Scale (CMS) pre- and post-surgery.
- Application of reliable change indices (RCI) and standardized regression-based (SRB) change scores to classify memory changes.
- Development and internal validation of logistic regression models to predict memory decline.
Main Results:
- Most children (54-69%) showed no significant memory change; 8-14% improved; 23-33% declined at a median of 7 months post-surgery.
- RCI and SRB change distributions were not significantly different.
- Preoperative memory score, surgery side/extent, and full-scale IQ predicted memory decline.
- Validated prediction models (concordance 0.70-0.75) showed good calibration but slightly overestimated decline risk in high-risk patients.
Conclusions:
- Empirical methods reliably characterize memory outcomes post-temporal lobe resection in pediatric epilepsy.
- Predictive models and tools (nomograms, calculator) are available to estimate individual patient risk for memory decline before surgery.
- These tools can assist clinicians in managing expectations and planning interventions.
