小児医学および外科ジャーナル

抽象的な

Using Electrical Stimulation and Linguistic Mapping to Improve Neuropsychological Results in Children Who had Surgery for Epilepsy

Ravindra Arya

Purpose: We studied the association between electrical stimulation mappings (ESM) with a visual picking task and post-operative neuropsychological issue after pediatric epilepsy surgery.

Methods: Children, who passed epilepsy surgery, having pre- and 1- time post-surgery neuropsychological evaluation (NPE) available, were included. NPE scores were converted using top factors (PC) analysis. The relationship between post-surgical PC scores, acclimated for pre-surgery PC scores, and ESM was anatomized. Clinical variables impacting this relationship were also sought.

Results: One hundred and four children (89 cases> 5 times-old, and 15 cases 3 −5 times-old) were included. Among children> 5 times- of- age, a significant effect of language ESM was observed on all 3post-surgery PC scores acclimated for separatepre-surgery PC scores. Specifically, only 30 cases who passed language ESM had a drop in PC1 scores ≥ 1- time after epilepsy surgery, compared to 68 those who didn't suffer language ESM( p = 0.001). Seizure issues, age at the time of surgery, predominant seizure type, and family history of epilepsy were other significant determinants of post-surgical PC scores including a change in PC scores from pre-surgery birth. Combinations of pre-surgical variables were suitable to prognosticate post-surgical PC scores with high particularity. In children progressed 3 −5 times, no significant effect of language ESM was seen onpost-surgery PC scores acclimated for separator-surgery PC scores.

Conclusions: Speech/ language ESM should be performed more extensively in cases> 5 times- of- age witnessing epilepsy surgery. Also, more effective brain mapping ways and language paradigms are demanded for youngish children.