Puka Klajdi, Khattab Maryam, Kerr Elizabeth N, Smith Mary Lou
Department of Psychology, The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8, Canada.
Department of Psychology, University of Toronto Mississauga, 3359 Mississauga Rd, Mississauga, ON L5L 1C6, Canada.
Epilepsy Behav. 2015 Jun;47:1-5. doi: 10.1016/j.yebeh.2015.04.062. Epub 2015 May 15.
Few studies have examined the academic functioning of children following pediatric epilepsy surgery. Although intellectual functioning has been more thoroughly investigated, children with epilepsy may experience additional difficulties with academic skills. This study examined the academic outcomes of a cohort of children who underwent pediatric epilepsy surgery on an average 1.2 (standard deviation [SD]: 0.3) years prior.
Participants were 136 children (mean age: 14.3 years, [SD]: 3.7 years) who had undergone resective epilepsy surgery. Academic functioning was assessed presurgery and postsurgery using standardized tests of reading, reading comprehension, arithmetic, and spelling.
At baseline, 65% of the children displayed low achievement (1 SD below test mean), and 28% had underachievement (1 SD below baseline IQ) in at least one academic domain. Examining change over time revealed that reading, numeral operations, and spelling significantly declined among all patients; seizure freedom at follow-up (attained in 64% of the patients) did not influence this relationship. Reading comprehension and IQ remained unchanged. Similar findings were found when examining patients with a baseline IQ of ≥ 70 and when controlling for IQ. Regression analyses revealed that after controlling for IQ, demographic and seizure-related variables were not significantly associated with academic achievement at follow-up.
Results show baseline academic difficulties and deteriorations following surgery that go beyond IQ. Further investigations are required to determine whether the observed deteriorations result from the development of the child, the course of the disorder, or the epilepsy surgery itself. Long-term studies are warranted to identify the progression of academic achievement and whether the observed deteriorations represent a temporal disruption in function.
很少有研究考察小儿癫痫手术后儿童的学业功能。尽管智力功能已得到更全面的研究，但癫痫儿童在学业技能方面可能还会遇到其他困难。本研究考察了一组平均在1.2（标准差[SD]：0.3）年前接受小儿癫痫手术的儿童的学业结果。
参与者为136名接受了切除性癫痫手术的儿童（平均年龄：14.3岁，[SD]：3.7岁）。术前和术后使用标准化的阅读、阅读理解、算术和拼写测试对学业功能进行评估。
在基线时，65%的儿童在至少一个学业领域表现出低成就（低于测试平均分1个标准差），28%的儿童表现出学业不良（低于基线智商1个标准差）。对随时间变化的考察显示，所有患者的阅读、数字运算和拼写能力均显著下降；随访时无癫痫发作（64%的患者达到）并未影响这种关系。阅读理解和智商保持不变。在检查基线智商≥70的患者以及控制智商时也发现了类似的结果。回归分析显示，在控制智商后，人口统计学和癫痫相关变量与随访时的学业成绩无显著关联。
结果显示手术前存在学业困难，且术后学业成绩恶化，这种恶化超出了智商的影响。需要进一步研究以确定观察到的恶化是由于儿童的发育、疾病进程还是癫痫手术本身。有必要进行长期研究以确定学业成绩的进展情况，以及观察到的恶化是否代表功能的暂时中断。
