NEUROPSYCHOLOGICAL EFFECT OF TEMPORAL-LOBE RESECTION IN PREADOLESCENTCHILDREN WITH EPILEPSY

Purpose: Numerous studies have demonstrated changes in cognitive. memo ry, and language functioning in adults and adolescents after temporal lobectomy, yet little information is available regarding neuropsycholo gical outcome in preadolescent children. Methods: We studied pre- and postoperative neuropsychological test results from I4 children who und erwent temporal lobe resection for intractable epilepsy at age 7-12 ye ars (mean 9.4 years). Results: Thirteen patients (93%) had no seizures or less than one seizure a year at follow-up 23-48 months (mean 34 mo nths) after operation. Postoperative neuropsychological testing was pe rformed 6-9 months (mean 7 months) after surgery in 13 patients and 36 months after the first operation in I patient who underwent two-stage resection of a tumor. Verbal, Performance, and Full Scale IQ were ini tially in the low average range, with no significant change across the pre- and postoperative evaluations. Immediate verbal memory perfor ma nce decreased significantly in children who initially performed above the median preoperatively and tended to decrease in children who had l eft rather than right temporal lobe resection. Significant postoperati ve decreases in delayed memory scores were independent of preoperative ability or side of resection. Conclusions: Our small study suggests v ulnerability to postoperative decline in immediate verbal memory score s in preadolescent children who have higher baseline immediate memory function or undergo left rather than right temporal lobe resection, si milar to that observed in adolescents in adults. The entire group exhi bited a statistically significantly decrease in delayed verbal memory. Study of larger series of patients will be important to clarify furth er the short- and long-term risks and benefits of temporal lobe resect ion in childhood.