Cognitive, psychosocial, and family function one year after pediatric epilepsy surgery.

Purpose: Assumptions regarding the benefits of seizure control after pediatric epilepsy surgery for cognitive, psychosocial, and family function were explored in a prospective study of 51 children with intractable epilepsy.

Methods: Thirty children who underwent surgery were studied before and 1 year after surgery, and a comparison group of 21 children with medically refractory seizures was examined at comparable times.

Results: One year after surgery, 57% of the surgical group was seizure free.

Cognitive and psychological predictors of everyday memory in children with intractable epilepsy.

Children with epilepsy have known deficits on objective measures of learning and memory. Parents and children report that memory deficits have a negative impact on everyday functioning. In adults with epilepsy, self-report of memory is more strongly associated with depression than performance on memory tests.

The significance of ear plugging in localization-related epilepsy.

Purpose: The localizing value of ear plugging in the treatment of auditory onset partial seizures, to our knowledge, has not been previously described. We propose that ear plugging is a clinical response to a sensory seizure manifested as an auditory hallucination and a tool for identifying the seizure focus in the auditory cortex on the superior temporal gyrus.

Methods: We report on three children who had prior epilepsy surgery for recurrent symptomatic localization-related epilepsy and who, subsequent to their surgery, displayed stereotyped unilateral or bilateral ear plugging at the onset of partial seizures.

Factors associated with atypical speech representation in children with intractable epilepsy.

The purpose of this study was to investigate the relationship between hemispheric speech dominance and several demographic and seizure variables in a large sample of children (N=75) who underwent the intracarotid amobarbital procedure (IAP) prior to surgery. The findings were similar to results previously reported in adults and children, suggesting that variables, such as age at seizure onset, laterality of seizure focus, location of seizure focus and handedness are related to the presentation of atypical speech representation in children with epilepsy. The impact of multiple variables in determining the risk for atypical speech dominance was also assessed.

Adolescent and Maternal Perspectives of Quality of Life and Neuropsychological Status Following Epilepsy Surgery.

A convenience sample of 13 adolescents who had undergone epilepsy surgery and their mothers reported their perceptions of change in areas affecting quality of life (physical, affect/behavior, social, cognition/academics, and family). A mixed method approach was used, with self-report and maternal-report narratives (qualitative measures), as well as neuropsychological profiles (quantitative measures). The results demonstrate that change after epilepsy surgery is multifaceted, and that adolescent and maternal perceptions are notably different.

Memory in children with temporal or extra-temporal excisions.

Memory was assessed before and after surgery in 44 children and adolescents with focal epilepsy who underwent either right temporal, left temporal or extra-temporal excisions. Measures included tests of verbal (story recall, and verbal list learning) and visually mediated (recall of a complex design, face recognition) memory. Changes in children's memory from pre- to post-operative assessment were examined and individual differences in outcome were evaluated.

Single and Dual Pathologies of the Temporal Lobe: Effects on Cognitive Function in Children with Epilepsy.

The neuropathologies associated with temporal lobe epilepsy (TLE) are heterogeneous. The performance of 61 children with single pathology of hippocampal sclerosis (HS), temporal lobe tumor, or cortical dysplasia (CD) or dual pathology of HS + tumor or HS + CD was examined on measures of intelligence, language, memory, and executive function. Children with single pathologies performed significantly better than did children with HS + CD on all standardized measures of IQ.

Predictors of Intelligence after Temporal Lobectomy in Children with Epilepsy.

Performance on standardized measures of intelligence was examined before and after temporal lobectomy in 50 children and adolescents. Group results showed small positive changes in Performance IQ (PIQ), but not Verbal IQ (VIQ). Analyses of individual patients showed that 28% had a significant change in VIQ after surgery, half of whom showed improvements.

Cognitive development in school-age children with vertically transmitted HIV infection.

We examined a broad range of neuropsychological functioning in school-age children with vertically transmitted HIV infection and a control group made up of siblings of children with HIV infection. Fourteen children with HIV (2 asymptomatic, 8 mildly symptomatic, and 4 with AIDS) and 11 control children were administered a battery of neuropsychological tests assessing intelligence, receptive language, expressive language, visual and verbal memory, visual-motor speed and coordination, visual-motor and visual-spatial processing, fine motor skill, and academic achievement. Results revealed that school-age children with vertically transmitted HIV infection show many areas of cognitive function within the normal range.

Working memory performance predicts subjective cognitive complaints in HIV infection.

The authors examined the contribution of working memory performance to subjective cognitive complaints in HIV infection beyond the influence of depressive symptoms. Thirty-six adults with HIV infection were administered neuropsychological (NP) tests of working memory, complex psychomotor efficiency, verbal learning, delayed recall, and questionnaires measuring depressive symptoms and cognitive complaints. Working memory performance, depression scores, and complex psychomotor efficiency were most strongly associated with self-reported cognitive complaints, whereas verbal learning scores and simple psychomotor efficiency showed more modest associations.

Developmental patterns in priming and familiarity in explicit recollection.

Developmental trajectories of two classes of human memory, implicit and explicit memory, appear to diverge. We examined how developmental differences in perceptual and conceptual priming, two types of implicit memory, coincide with differences between familiarity and recollective responses on explicit memory tests that employ the Remember/Know paradigm ( Tulving, 1985 ). Both types of priming were characterized by developmental invariance in 52 children and adolescents ages 8-19 years.

Cognitive skills in children with intractable epilepsy: comparison of surgical and nonsurgical candidates.

Purpose: To compare neuropsychological performance of two groups of children with intractable epilepsy: those who are surgical candidates, and those who are not.

Methods: Intelligence, verbal memory, visual memory, academic skills, and sustained attention were measured in children aged 6-18 years. The effects of number of antiepileptic drugs (AEDs), seizure frequency, age at seizure onset, and duration of seizure disorder were examined.

The impact of age at seizure onset on the likelihood of atypical language representation in children with intractable epilepsy.

Studies have suggested that early postnatal lesions are associated with a greater likelihood of atypical speech representation than lesions acquired later in life. Comparison groups have been defined differently across studies, with age typically being treated as a dichotomous (i.e.

Language after temporal or frontal lobe surgery in children with epilepsy.

The purpose of this study was to compare language function in children undergoing temporal or frontal lobe surgery to control intractable epilepsy. Language measures (expressive vocabulary, receptive vocabulary, comprehension, reading, spelling, phonemic fluency, and category fluency) were administered to 9 children with frontal lobe epilepsy (mean age: 10.8 +/- 2.

Intact perceptual and conceptual priming in temporal lobe epilepsy: neuroanatomical and methodological implications.

Explicit memory appears to be supported by medical temporal lobe structures, whereas separate neocortical regions may mediate perceptual and conceptual implicit memory. Children and adults with temporal lobe epilepsy (TLE) and matched controls were administered experimental verbal memory tests. Performance on implicit tests--word identification and word generation--was contrasted with explicit recognition and recall.