Language development before and after temporal surgery in children with intractable epilepsy
| Autor: | Monique M.J. van Schooneveld, Philippe H. Dejonckere, Trudi De Koning, Aag Jennekens-Schinkel, Peter C. van Rijen, Huib Versnel, Onno van Nieuwenhuizen |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Language delay media_common.quotation_subject medicine.medical_treatment Drug Resistance Mothers Lexicon Language Development Functional Laterality Developmental psychology Temporal lobe Risk Factors Preoperative Care medicine Humans Epilepsy surgery Language Development Disorders Longitudinal Studies Child Anterior temporal lobectomy media_common Language Tests Grammar Linguistics Anterior Temporal Lobectomy Syntax Temporal Lobe Surgery Language development Neurology Epilepsy Temporal Lobe Educational Status Female Neurology (clinical) Psychology Follow-Up Studies |
| Zdroj: | Epilepsia. 50(11) |
| ISSN: | 1528-1167 |
| Popis: | Purpose: To obtain systematic knowledge oflanguage development before and after epilepsysurgery in regions that, if damaged, are known toentaillanguageimpairmentinadults.Methods: Twenty-four children (mean age11 years; range 5.8–15.7 years) with pharmacolog-ically intractable epilepsy participated prior to(the majority) anterior temporal lobectomy and6, 12, and 24 months thereafter. Reception andproduction of lexicon (vocabulary) and syntax(sentence structure including grammar) wereexamined using developmental language teststhatprovidenormativedata.Results: Prior to surgery the mean language delayvaried from 1.7 years (productive syntax) to3.5 years (productive lexicon). For lexicon, lan-guage delay was larger, the older the children; forsyntaxitwassmallerinchildrenwithmotherswithhigher education. Over the 2 years following sur-gery, the children developed in all four languagecomponents. Development was, however, slowerthan normal, that is, language delay increased, inthree of the four components: in productive lexi-con it continued to increase, and in receptive lexi-con and productive syntax it appeared to stabilizeduring the second year. Receptive syntax devel-oped at a normal pace. The development of pro-ductivelexiconwasremarkablyslowwhensurgeryand language mediation were both in the lefthemisphere.Discussion:Pharmacologicallyintractableepilepsyof the temporal lobe, or the underlying condition,is a significant risk factor for delayed languagedevelopment. Temporal epilepsy surgery does notresult in acceleration of language development. Iflanguage is still mediated in the operated lefthemisphere, development of particular languagecomponentsmayslowdownaftersurgery.KEY WORDS: Pediatric, Syntax, Lexicon, Assess-ment,Delay.Resective surgery in children with pharmacologicallyintractable temporal lobe epilepsy reduces seizures orevenleadstotheircessation. Theriskofinflictingdamageto developing cognitive functions such as language,although of major concern in the decision process for oragainst epilepsy surgery in a child, is not yet clear. If theepileptogenic zone necessitates resection of cerebral lefttemporal areas, tissue may be sacrificed that, at least inadults, is essential for language mediation. After pediatricepilepsy surgery, both decline and improvement of lan-guage have been observed during 1 year after surgery(Williams et al., 1998; Dlugos et al., 1999; Lendt et al.,1999; Bell et al., 2002; Sinclair et al., 2003; Gleissneret al., 2005). These previous studies addressed wider cog-nitive functioning and were linguistically limited to spe-cific components such as productive lexicon (naming) orreceptive syntax (understanding of sentences). An impor-tantquestioncancurrentlynotbeanswered,viz.,howdoestheepilepsysurgeryaffectthedevelopmentoflanguageinthese children? To address this question, we examined a |
| Databáze: | OpenAIRE |
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