Cognitive assessment in epilepsy surgery of children

Although the neurocognitive assessment in children as in the adults is an important step before and after surgery, in the literature, the data about pre- and postoperative neurocognitive evaluations in children are very few. The purpose of this paper is to consider some peculiar aspects of the neurocognitive assessment during development, and report literature data about neuropsychological outcome of epileptic children treated with focal resection and hemispherectomy. The second section concerns our personal experience about a cohort of 45 children with refractory epilepsy operated on before 7 years. The results suggest that early surgical treatment is generally effective for seizure control and behavior improvement in children with refractory epilepsy. Concerning cognitive outcome, we found that the neurocognitive level was unchanged in the majority of the patients. We underline the importance of multicentric studies with standardized neuropsychological assessments in large series of young children.