WASHINGTON, DC—Epilepsy surgery may improve mood and behavior among children, researchers reported at the 67th Annual Meeting of the American Epilepsy Society (AES). The hemisphere on which surgeons operate may influence the effect of surgery.
Children with epilepsy are at high risk for depression, anxiety, and behavioral functioning disorders. Epilepsy surgery in children is associated with changes or improvements in mood and behavior, but research into the extent of the change has produced inconsistent results.
To examine changes in mood, anxiety, and behavioral functioning following epilepsy surgery, a collaborative team of investigators from the Cleveland Clinic and the University of Pittsburgh studied 101 children (ages 5 to 16) who underwent epilepsy surgery. The investigators analyzed the role of surgical site (ie, frontal or temporal) and hemisphere (ie, left or right) in the outcomes.
Children in the study completed the Children’s Depression Inventory (CDI) and the Revised Children’s Manifest Anxiety Scale (RCMAS) as part of comprehensive neuropsychologic evaluations conducted approximately 10 months apart. The children’s primary caregivers completed the Achenbach Child Behavior Checklist (CBCL) at both evaluations.
Among children who underwent left-sided surgeries, patients with frontal lobe epilepsy or their caregivers endorsed more symptoms on the Social Anxiety subscale of the RCMAS and on the Withdrawal subscale of the CBCL before surgery than patients with temporal lobe epilepsy. Patients with frontal lobe epilepsy also demonstrated notable improvement in anxiety or mood following surgery. The investigators found no significant two-way interactions among children who underwent right-sided surgeries.
In addition, 21% of all patients (ie, 15% of patients with temporal lobe epilepsy and 33% of patients with frontal lobe epilepsy) reported improvements in overall depression symptoms after surgery. About 38% of the cohort (ie, 27% of patients with temporal lobe epilepsy and 45% of patients with frontal lobe epilepsy) reported postoperative improvements in overall anxiety symptoms.
“We were pleased to discover that children generally experience improvements in mood and behavior following epilepsy surgery,” said Elizabeth Andresen, PhD, postdoctoral fellow in neuropsychology at the Cleveland Clinic and lead author of the study. “While children with frontal lobe epilepsy had greater symptoms of depression and anxiety before surgery than children with temporal lobe epilepsy, these symptoms improved significantly following surgery to levels comparable to or below [those of] the temporal lobe group. Interestingly, these relationships were most apparent in children who underwent left-sided surgeries.”
—Erik Greb