Infantile spasms: the development of nonverbal communication after epilepsy surgery.

The postoperative development of nonverbal communication was studied in 29 children, aged 18.2 (SD = 11.54) months, who underwent multilobar resection or hemispherectomy for intractable symptomatic infantile spasms (IS). Using the Early Social Communication Scale, the IS subjects had little, if any, social interaction, joint attention or behavior regulation before surgery. After a mean follow-up of 24 months, most of the children continued to have delayed nonverbal communication skills compared to normal children. Seizure-related, surgical and cognitive factors were unrelated to the postsurgical development of nonverbal communication. The children with right-sided surgery had a statistically significant increase in the use of social interaction but not in other gestural behaviors. Removal of the frontal lobe was not related to the nonverbal communication outcome. The study's findings suggest that impaired use of nonverbal communication might be a feature of surgically treated children with medically intractable IS.