Alice E Flint1, Mitch Waterman2, Grace Bowmer3, Gayatri Vadlamani4, Paul Chumas5, Matthew C H J Morrall6. 1. Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, United Kingdom; Paediatric Neuropsychology, E Floor, Martin Wing, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, United Kingdom. Electronic address: alice.flint@sssft.nhs.uk. 2. Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, United Kingdom. Electronic address: m.g.waterman@leeds.ac.uk. 3. Paediatric Neuropsychology, E Floor, Martin Wing, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, United Kingdom. Electronic address: grace.bowmer@nhs.net. 4. Paediatric Neurology, F Floor, Martin Wing, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, United Kingdom. Electronic address: gayatri.vadlamani@nhs.net. 5. Department of Neurosurgery, G Floor, Jubilee Wing, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, United Kingdom. Electronic address: p.chumas@nhs.net. 6. Paediatric Neuropsychology, E Floor, Martin Wing, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, United Kingdom. Electronic address: m.morrall@nhs.net.
Abstract
OBJECTIVE: The systematic review aimed to assess the neuropsychological outcomes of temporal lobe resections for epilepsy in children. Additional objectives included determining whether earlier age at surgery leads to better neuropsychological outcomes; the relationships between and predictors of these outcomes. METHODS: Using advanced search terms, a systematic review of electronic databases was conducted, comprising MEDLINE, Embase, PsycINFO, Global Health, Web of Science and CINAHL. Included studies reported on outcome following neurosurgical treatment for epilepsy. Specifically, studies were included if they reported neuropsychological outcomes and were concerned only with temporal lobe resection. RESULTS: 73 studies met inclusion criteria. For reported neuropsychological outcomes, the majority of participants remained stable after surgery; some declined and some improved. There was some evidence for increased material-specific memory deficits after temporal lobe surgery based on resection side, and more positive cognitive outcome for those with lower pre-surgical ability level. SIGNIFICANCE: Retrieved evidence highlights the need for improvements to quality of methodology and reporting. Appropriately designed prospective multicentre trials should be conducted with adequate follow-up for long-term outcomes to be measured. Core outcome measures should be agreed between centres. This would permit higher quality evidence so that clinicians, young people and their families may make better informed decisions about whether or not to proceed with surgery and likely post-operative profile.
OBJECTIVE: The systematic review aimed to assess the neuropsychological outcomes of temporal lobe resections for epilepsy in children. Additional objectives included determining whether earlier age at surgery leads to better neuropsychological outcomes; the relationships between and predictors of these outcomes. METHODS: Using advanced search terms, a systematic review of electronic databases was conducted, comprising MEDLINE, Embase, PsycINFO, Global Health, Web of Science and CINAHL. Included studies reported on outcome following neurosurgical treatment for epilepsy. Specifically, studies were included if they reported neuropsychological outcomes and were concerned only with temporal lobe resection. RESULTS: 73 studies met inclusion criteria. For reported neuropsychological outcomes, the majority of participants remained stable after surgery; some declined and some improved. There was some evidence for increased material-specific memory deficits after temporal lobe surgery based on resection side, and more positive cognitive outcome for those with lower pre-surgical ability level. SIGNIFICANCE: Retrieved evidence highlights the need for improvements to quality of methodology and reporting. Appropriately designed prospective multicentre trials should be conducted with adequate follow-up for long-term outcomes to be measured. Core outcome measures should be agreed between centres. This would permit higher quality evidence so that clinicians, young people and their families may make better informed decisions about whether or not to proceed with surgery and likely post-operative profile.
Authors: Michal Hrdlicka; Martin Kudr; Pavel Krsek; Michal Tichy; Martin Kyncl; Josef Zamecnik; Marketa Mohaplova; Iva Dudova Journal: J Autism Dev Disord Date: 2019-12