Abstract |
Mild malformation of cortical development ( mMCD) and focal cortical dysplasia (FCD) subtypes combined are by far the most common histological diagnoses in children who undergo surgery as treatment for refractory epilepsy. In patients with refractory epilepsy, a substantial burden of disease is due to cognitive impairment. We studied intelligence quotient (IQ) or developmental quotient (DQ) values and their change after epilepsy surgery in a consecutive series of 42 children (median age at surgery: 4.5, range: 0-17.0 years) with refractory epilepsy due to mMCD/FCD. Cognitive impairment, defined as IQ/DQ below 70, was present in 51% prior to surgery. Cognitive impairment was associated with earlier onset of epilepsy, longer epilepsy duration, and FCD type I histology. Clinically relevant improvement of ≥10 IQ/DQ points was found in 24% of children and was related to the presence of presurgical epileptic encephalopathy (EE). At time of postsurgical cognitive testing, 59% of children were completely seizure-free (Engel 1A). We found no association between cognitive outcome and seizure or medication status at two years of follow-up. Epilepsy surgery in children with mMCD or FCD not only is likely to result in complete and continuous seizure freedom, but also improves cognitive function in many.
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Authors | Tim J Veersema, Monique M J van Schooneveld, Cyrille H Ferrier, Pieter van Eijsden, Peter H Gosselaar, Peter C van Rijen, Wim G M Spliet, Angelika Mühlebner, Eleonora Aronica, Kees P J Braun |
Journal | Epilepsy & behavior : E&B
(Epilepsy Behav)
Vol. 94
Pg. 209-215
(05 2019)
ISSN: 1525-5069 [Electronic] United States |
PMID | 30974349
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved. |
Topics |
- Adolescent
- Child
- Child, Preschool
- Cognitive Dysfunction
(etiology, surgery)
- Craniofacial Abnormalities
(complications, surgery)
- Drug Resistant Epilepsy
(complications, surgery)
- Epilepsies, Partial
(complications, surgery)
- Epilepsy
(complications, surgery)
- Female
- Follow-Up Studies
- Humans
- Infant
- Male
- Malformations of Cortical Development
(complications, surgery)
- Outcome Assessment, Health Care
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