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We report a longitudinal case study of a left-handed girl who underwent left hemispherotomy at 7 years for Rasmussen encephalitis (RE). Presurgical evaluation showed mild hemiparesis, no visual defect, and light neuropsychological impairment with short-term memory weakness. Language fMRI showed a right hemispheric dominance. Postoperatively, the patient exhibited right hemiplegia and hemianopsia but preserved intellectual capacities. She became seizure-free, and antiepileptic medication was discontinued. Long-term follow-up showed very high verbal intelligence at 11 years of age (VCI of 155) and improvement in working memory as well as language and reading abilities. Furthermore, a significant visuoverbal discrepancy became increasingly pronounced. Thus, early surgical treatment of epilepsy avoided the global cognitive deterioration usually associated with RE. Finally, such a high level of verbal functioning combined with low spatial reasoning with a single hemisphere provides additional information on the neurocognitive profile of children with RE after hemispherotomy. [ABSTRACT FROM AUTHOR]

We present a 16 year-old right-handed case who underwent a left temporo-occipital resection to treat intractable epilepsy. Pre- and post-surgical evaluations showed an average intellectual quotient, preserved abilities in language and visuo-spatial functions and increased reading and spelling deficits (difficulties with irregular words, homophones and phonologically valid spelling errors of irregularly spelled words, associated with preserved performances in non-words). This pattern of characteristic lexical route deficits highlights the major role of the temporo-occipital areas in reading acquisition. We discussed the consequences of temporo-occipital dysfunction on reading. [ABSTRACT FROM AUTHOR]

In cognitively impaired or young children with epilepsy, only proxy-report can be used for the assessment of Quality of Life (QOL) and behavior. The present study aims to propose proxy QOL tools applicable in all children with epilepsy and to examine the impact of epilepsy characteristics (e.g., age of onset of epilepsy, epilepsy syndrome) and child's age and situation (in mainstream school or in special institution). We studied 219 children with various types of epilepsy with and without cognitive impairment. The study adapted published QOL scales and used a new parental QOL questionnaire. Selected items concerned 6 “domains” of QOL: global QOL, illness impact, depression/anxiety, hyperactivity/disrupting behavior, sociability, and parental QOL. School situation, epilepsy syndrome, and age were significantly and differentially related to the QOL domains. The proposed QOL tools are applicable to all children with epilepsy independently of comorbid conditions and can be used in a clinical context and for research studies of QOL in children with epilepsy. Epilepsy syndromes in children and their associated factors have a crucial impact on parental concerns and QOL. [ABSTRACT FROM AUTHOR]

Purpose: Paediatric neurological chronic conditions are often associated with physical, cognitive, psychological and behavioural difficulties that may affect quality of life (QOL) of children and their families. In this study, we compare parental report of difficulties and rehabilitation in children with various epileptic syndromes or treated for a benign or malignant brain tumour. Method: One hundred fifty-three children aged between 6 and 12 years were included, 119 with epilepsy (non-idiopathic generalized 31, non-idiopathic partial 62, idiopathic 26) and 34 treated for a brain tumour. Parents answered a multidimensional questionnaire on child's autonomy and cognitive or behavioural difficulties, impact of the illness on their own everyday life, and rehabilitation. Results: Learning difficulties were reported by a majority of parents in all groups. Behavioural and autonomy problems were more often reported in the non-idiopathic generalized epilepsy group. Report of tiredness was more frequent and of disrupting behaviour less frequent in the tumour group than in epilepsy. Impact of the child's illness on parents' QOL was strong in all groups, and stronger in case of severe forms of epilepsy. Conclusions: Parental concerns are important to consider for rehabilitation programmes adapted to each child with these neurological conditions. [ABSTRACT FROM AUTHOR]

Various methods have recently been proposed to assess the physical, psychological or social dimensions of quality of life (QoL) in children with epilepsy (CwE) and their families. Some methods are based exclusively on parental report and others emphasize the importance of an interview with the patient himself. In children with epilepsy and severe cognitive deficit only parental report is possible in practice; however, some parental based methods to evaluate QoL in CwE have excluded children with cognitive deficit. The present pilot study explores which items are suitable for a parental-based QoL evaluation in CwE and special educational needs, and the most frequently reported parental concerns in this special population of children. [ABSTRACT FROM AUTHOR]