Visual memory after epilepsy surgery in children: a standardized regression-based analysis of group and individual outcomes.

Visual memory is vulnerable to epilepsy surgery in adults, but studies in children suggest no change or small improvements. We investigated visual memory after epilepsy surgery, both group-wise and in individual children, using two techniques to assess change: 1) repeated measures analysis of variance (ANOVA) and 2) an empirically based technique for detecting cognitive change [standardized regression-based (SRB) analysis]. A prospective cohort consisting of 21 children completed comprehensive assessments of memory both before surgery (T0) and 6 (T1), 12 (T2), and 24 months (T3) after surgery.

The lesioned brain: still a small-world?

The intra-arterial amobarbital procedure (IAP or Wada test) is used to determine language lateralization and contralateral memory functioning in patients eligible for neurosurgery because of pharmaco-resistant epilepsy. During unilateral sedation, functioning of the contralateral hemisphere is assessed by means of neuropsychological tests. We use the IAP as a reversible model for the effect of lesions on brain network topology.

The effect of the new antiepileptic drug rufinamide on cognitive functions.

Purpose: Rufinamide (RUF 331; 1-(2,6-difluoro-phenyl)methyl-1H-1,2,3-triazole-4-carboxamide) is a structurally novel compound that limits the frequency of sodium-dependent neuronal action potentials. So far no data have been published on the cognitive effects of RUF, except for two animal studies.

Methods: The study used a multicenter, multinational double-blind, randomized, placebo-controlled parallel-study design with four different doses of RUF (based on prior studies): 200 mg/day, 400 mg/day, 800 mg/day, and 1,600 mg/day as add-on to the existing medication.

The effects on cognitive performance of tailored resection in surgery for nonlesional mesiotemporal lobe epilepsy.

Purpose: Mesiotemporal lobe epilepsy (MTLE) can be treated with different surgical approaches. In tailored resections, neocortex is removed beyond "standard" margins when spikes are present in the electrocorticogram. We hypothesized that these larger resections are justified because spiking neocortex is dysfunctional.

Recognition memory of serially or simultaneously presented words or figures, of epilepsy patients with or without mesial temporal sclerosis.

Previous studies, examining short-term recognition memory in patients with partial seizures as a consequence of mesial temporal sclerosis (MTS) have reported inconsistent findings. Dependent on the paradigms used for measuring recognition memory, some studies have demonstrated that the mesial temporal structures are not critically involved in short-term recognition memory. In addition, other studies found a lateralization effect that is consistent with the generally accepted association between left temporal lobe lesions and verbal memory deficits, and right temporal lobe lesions and non-verbal memory impairments.

Diagnostic significance of Wada procedure in very young children and children with developmental delay.

Localization of vital components of neurological functioning has to be performed before epilepsy surgery can be considered in children with intractable epilepsy. This study reports the experience with the Wada procedure in very young children and/or developmentally delayed children with an a priori considerable chance of failing the procedure. The aim of this study was to indicate the applicability of this procedure in this patient group.