Memory in Children with Temporal and Frontal Lobe Epilepsy, Pre- and Post-Operatively



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Temporal lobe epilepsy (TLE) has been shown to be related to cognitive impairments in adults and children. This study specifically focuses on the cognitive impairments that can be associated with surgical intervention for intractable epilepsy in children. In adults, there is evidence for material-specific memory decline such that those with L-TLE have impaired verbal memory while those with R-TLE tend to have impaired visual memory, though the latter results are less robust. In children, the results are mixed suggesting that both verbal and visual memory can be affected by L- or R-sided TLE. In the current study, measures of objective memory, including immediate, delayed, and recognition memory, as well as verbal and non-verbal memory, everyday memory, and academic skills were considered pre- and post-surgery in children with TLE as well as in comparison groups of children with surgical intervention for frontal lobe epilepsy (FLE), for parietal or occipital lobe epilepsy, and children who have not had surgery. The impact of seizure-related variables, including seizure frequency, change in medications, age at surgery, age of onset of seizures, follow-up interval, and involvement of the hippocampus was explored. Results showed that the Surgery and No Surgery groups differed on academics: children without surgery declined but the surgery group were unchanged. The combined TLE and FLE group performed worse than children with parietal or occipital surgery on measures of objective memory, though neither group changed significantly. The combined TLE groups declined on immediate and delayed memory while the FLE improved. Finally, this study was consistent with the current literature for lack of evidence to support material-specific decline or improvement after surgery in the L- and R-TLE groups. Only the different etiologies (MTS, tumor, cortical dysplasia, etc.) may have impacted performance in the TLE group. While there was evidence for decline in immediate and delayed memory for the TLE groups, this does not appear to affect everyday memory or academic functioning.



Epilepsy, Children