Pediatric Neurology Part I: Chapter 82. Cognitive outcome of surgery

Pediatric Neurology Part I: Chapter 82. Cognitive outcome of surgery
ISBN-10
0128077875
ISBN-13
9780128077870
Series
Pediatric Neurology Part I
Category
Medical
Pages
892
Language
English
Published
2013-04-24
Publisher
Elsevier Inc. Chapters
Authors
Maryse Lassonde, Isabelle Jambaqué, Anne Gallagher

Description

Epilepsy surgery is now widely accepted as an effective therapeutic option for carefully selected children with medically refractory epilepsy. The surgical procedure may cause cognitive deficits or exacerbate existing impairments, but it may also improve cognitive abilities by the restoration of functions located in adjacent or contralateral areas that had been secondarily affected by the epilepsy or the underlying pathology. Compared to adults, better cognitive outcome has been reported in children, a finding probably due to the developing state of the brain, which possesses considerable structural and functional plasticity. More extensive and effective surgery such as hemispherectomy is more commonly used in the pediatric population, and this must also influence surgical outcome. However, studies related to cognitive outcome of epilepsy surgery in children are limited, and controversial results are often reported. In this chapter, we provide a current overview of the literature on cognitive outcomes in children who undergo different types of epilepsy surgery, including focal resections as well as corpus callosotomy and hemispherectomy. Early surgical intervention appears to be a rational option for the treatment of childhood epilepsy since many cognitive deficits are linked to the epileptic process and may disappear when seizures are controlled.

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