A new study published in the journal, Epilepsia, suggests that short-term improvements in memory following childhood epilepsy surgery might not be sustained in the long term.These findings may be helpful for physicians, people with epilepsy and their families to better understand the possible outcomes of epilepsy surgery in childhood, and the effects of continuing antiepileptic drug (AED) treatment.For the study, Klajdi Puka and Dr Mary Lou Smith, at the University of Toronto, analysed the verbal and visual memory skills of 88 people (average age 20.05 years) who had been diagnosed with drug-resistant epilepsy in childhood, and who had undergone evaluation for surgical treatment. Fifty-three of the subjects had actually undergone epilepsy surgery – between 4 and 11 years earlier – and the remaining 35 served as non-surgical controls. The researchers used standardised recall tests (involving stories, faces, word pairs and word lists) to assess the participants’ memory abilities, and they compared the results to those the subjects had achieved during surgical evaluation. Please note: the older tests were performed at what is referred to as the baseline time point, whilst the new ones were long-term follow-up assessments.When the team analysed the results, they found no improvement in the subjects’ memory abilities over time (i.e. between baseline and follow-up). They also discovered that the participants’ memory outcomes were largely independent of whether or not they had undergone surgery.People who were seizure-free at follow-up were shown to have better story recall at both time points than those who weren’t, but no improvement in their scores was found between the time points.For subjects with epilepsy outside of the temporal lobe (extra-temporal lobe epilepsy), word list recall significantly declined over time regardless of whether or they had undergone surgery, or what their seizure status was.The side of the seizure focus (the region in which seizures originate) only appeared to make a difference in people with temporal lobe epilepsy – those with left temporal lobe epilepsy (TLE) achieving lower story recall scores at follow-up than those with right TLE.The researchers also observed that participants who underwent surgery tended to achieve seizure freedom sooner (if they did at all), and use fewer AEDs at follow-up, than those who did not.The authors conclude from this that memory outcomes in the long term are independent of surgical status, and that there appears to be no improvement in memory performance over time, even in people who are seizure-free at follow-up. They also note, however, that surgery may be linked to more prompt seizure freedom and the need for fewer AEDs at follow-up.Children with epilepsy can experience difficulties with many types of memory, including episodic memory (memory of events), semantic memory (memory of abstract concepts) and autobiographical memory. They are also prone to abnormally rapid forgetting. This is the first study to examine the long-term effect of surgery on memory.Author: Dr Özge ÖzkayaClick here for more articles about other treatments for epilepsy.
ERUK Team2019-10-26T22:53:23+01:00October 14th, 2016|