Epilepsy surgery in children with pervasive developmental disorder

C. Ákos Szabó, Elaine Wyllie, Michelle Dolske, Lisa D. Stanford, Prakash Kotagal, Youssef G. Comair

Research output: Contribution to journalArticle

44 Scopus citations

Abstract

Pervasive developmental disorder (PDD) is occasionally associated with medically intractable complex partial seizures. The outcome of PDD was explored in three males and two females who underwent epilepsy surgery at 32 months to 8 years of age (mean = 4 years) after onset of epilepsy at 1 week to 21 months of age (mean = 11 months). Four children had temporal lobe resections (three right, one left; two for focal cortical dysplasia, and two for tumors), and one had a right temporoparieto-occipital resection (for focal cortical dysplasia). Each child underwent repeated evaluations by a pediatric neuropsychologist and psychiatrist. Fourteen to 47 months (mean = 23 months) after operation, one child with persistent seizures had moderate developmental and behavioral improvement, three children (two seizure free, one with rare staring spells) had mild developmental and behavioral improvement, and the remaining child (seizure free) experienced a worsening of her PDD. The four children with mild-to-moderate improvement in postoperative cognitive and behavioral development still demonstrated persistent delay. Cognitive gains were confirmed by neuropsychologic testing in the oldest patient but were not reflected in test results from the three younger children, who had more modest improvement. The child with worsening of her PDD had cognitive and emotional deterioration to babbling, echolalia, aggressiveness, decreased social interaction, and increased mouthing of objects beginning several months postoperatively. These results suggest that families should be counseled that PDD symptoms in children with focal epileptogenic lesions may or may not improve after epilepsy surgery, even if the surgery is successful with respect to seizure control.

Original languageEnglish (US)
Pages (from-to)349-353
Number of pages5
JournalPediatric Neurology
Volume20
Issue number5
DOIs
StatePublished - May 1 1999

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Neurology
  • Developmental Neuroscience
  • Clinical Neurology

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    Szabó, C. Á., Wyllie, E., Dolske, M., Stanford, L. D., Kotagal, P., & Comair, Y. G. (1999). Epilepsy surgery in children with pervasive developmental disorder. Pediatric Neurology, 20(5), 349-353. https://doi.org/10.1016/S0887-8994(99)00003-X