Impact of @entity302 surgery on development of preschool XXXX : identification of a cohort likely to benefit from early intervention.

@entity1 @entity410 @entity302
OBJECT: Outcomes of focal resection in young @entity1 with early-onset @entity302 are varied in the literature due to study differences. In this paper, the authors sought to define the effect of focal resection in a small homogeneous sample of @entity1 who were otherwise cognitively intact, but who required early surgical treatment. Preservation of and age-appropriate development of intelligence following focal resection was hypothesized. METHODS: Cognitive outcome after focal resection was retrospectively reviewed for 15 cognitively intact @entity1 who were operated on at the ages of 2-6 years for lesion-related, early-onset @entity302 . Intelligence was tested prior to and after surgery. Effect sizes and confidence intervals for means and standard deviations were used to infer changes and differences in intelligence between 1) groups (pre vs post), 2) left versus right hemisphere resections, and 3) short versus long duration of @entity410 prior to resection. RESULTS: No group changes from baseline occurred in Full Scale, verbal, or nonverbal IQ. No change from baseline intelligence occurred in @entity1 who underwent left or right hemisphere surgery, including no group effect on verbal scores following surgery in the dominant hemisphere. @entity1 with @entity410 durations of less than 6 months prior to resection showed improvement from their presurgical baseline in contrast to those with @entity410 duration of greater than 6 months prior to surgery, particularly in Wechsler Full Scale IQ and nonverbal intelligence. CONCLUSIONS: This study suggests that surgical treatment of focal @entity410 in cognitively intact preschool @entity1 is likely to result in @entity410 remediation, antiepileptic drug discontinuation, and no significant decrement in intelligence. The latter finding is particularly significant in light of the longstanding concern associated with performing resections in the language-dominant hemisphere. Importantly, shorter @entity410 duration prior to resection can result in improved cognitive outcome, suggesting that surgery for this population should occur sooner to help improve intelligence outcomes.
