Developmental outcomes of childhood-onset temporal lobe epilepsy: A community-based study

被引:24
作者
Wilson, Sarah J. [1 ,2 ,3 ]
Micallef, Silvana [1 ,2 ,3 ]
Henderson, Asawari [1 ]
Rayner, Genevieve [1 ]
Wrennall, Jacquie A. [4 ]
Spooner, Claire [5 ]
Harvey, A. Simon [4 ,6 ]
机构
[1] Univ Melbourne, Melbourne Sch Psychol Sci, Parkville, Vic 3010, Australia
[2] Austin Hlth, Comprehens Epilepsy Program, Melbourne, Vic, Australia
[3] Royal Childrens Hosp, Dept Psychol, Melbourne, Vic, Australia
[4] Royal Childrens Hosp, Childrens Neurosci Ctr, Melbourne, Vic, Australia
[5] Starship Childrens Hosp, Dept Neurol, Auckland, New Zealand
[6] Univ Melbourne, Dept Paediat, Parkville, Vic 3010, Australia
关键词
Cohort studies; Partial seizures; Outcome research; Neuropsychology; behavior; Pediatric; QUALITY-OF-LIFE; CHRONIC DISEASE; CHILDREN; SURGERY; TASKS; TRAJECTORIES; ADJUSTMENT; TRANSITION;
D O I
10.1111/j.1528-1167.2012.03632.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Purpose: To assess the impact of childhood-onset temporal lobe epilepsy (TLE) on the attainment of normative developmental tasks and identify predictors of long-term developmental outcomes. Methods: In 19921993, a prospective longitudinal cohort study of childhood-onset TLE was commenced in the State of Victoria, Australia. At review in 20042006, we assessed developmental tasks, which are age-specific individual psychosocial achievements tied to particular phases of the lifespan. The cohort comprised 54 individuals (33 female) with a mean age of 20 years (range 1229), and mean age at TLE onset of 6 years (range 0.215). Key Findings: Individuals were clustered into three groups representing distinct developmental trajectories: (1) a Normal group (52%) who achieved most of their developmental tasks, (2) an Altered group (37%) who achieved some, and (3) a Delayed group (11%) who achieved few. The groups showed significant cognitive differences, with the Normal group outperforming the Altered and Delayed groups on a range of measures (p < 0.05). Multiple discriminant function analysis indicated that membership of the groups was independently predicted by the chronicity of seizures, cognitive functioning, having surgically remediable epilepsy, and gender (p < 0.001). Seizure chronicity and cognition discriminated between all three trajectories, while surgical intervention and gender primarily discriminated between the Altered and Delayed trajectories. Significance: Childhood-onset TLE can disrupt achievement of normative developmental tasks that is independently predicted by medical, biologic, and cognitive factors. Assessment of developmental tasks across the lifespan provides a practical framework for guiding prognostic counseling of patients and families.
引用
收藏
页码:1587 / 1596
页数:10
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