EPILEPSY SURGERY OUTCOME - COMPREHENSIVE ASSESSMENT IN CHILDREN

The effect of extratemporal and temporal lobe cortical resection on ch ildren with intractable epilepsy is not well understood. We evaluated a comprehensive array of outcome variables in 33 consecutive children who received epilepsy surgery at 12 years of age or younger. Twenty-tw o (67%) children were seizure-free, three (9%) had a greater than 90% reduction in seizures, and four had no improvement. Antiepileptic drug s (AEDs) were not required in 10 (30%) children and were reduced in nu mber in another 10. Six (29%) of 21 tested children had an improvement of greater than 10 points in Verbal or Performance IQ after surgery, while one (4%) had a decrease greater than 10 points in Verbal IQ. One mild hemiparesis and one inferior quadrantanopsia occurred; both were anticipated. We used the Child Health Questionnaire (CHQ), a valid an d reliable instrument for children, to assess health-related quality o f life (HRQOL). Six of 12 subscale scores of the CHQ were significantl y lower in the surgical group compared with 410 age-matched control su bjects. Parents were satisfied with surgical results in 28 (85%) cases . Pathologic tissue diagnosis and site of resection were not associate d significantly with any outcome measure. We conclude that; surgery el iminates seizures and reduces AED requirements in most children with i ntractable epilepsy selected by currently available methods. Further i nvestigation is needed to establish the nature and significance of inf erior scores in the surgical group in the HRQOL domains of physical fu nction, general health, and self-esteem.