Highlights
- •Children with autism spectrum disorder and drug-resistant epilepsy can benefit from epilepsy surgery.
- •Even those children who cannot have resective surgery may benefit from a vagal nerve stimulator.
- •Epilepsy surgery is most effective when performed at a young age.
Abstract
Objective
The objective of this research was to evaluate a cohort of children with both autism
spectrum disorder (ASD) and drug-resistant epilepsy (DRE) after epilepsy surgery to
determine predictors of best outcome.
Methods
Retrospective chart review was done for 29 children ages 2 to 18 years with ASD and
DRE who had neurosurgical intervention for seizure management over 15 years at one
institution. All subjects had at least 1 year of follow-up. Data abstraction included
demographic information, seizure diagnosis, treatment, investigations, surgical intervention,
neuropsychological assessment, and outcome. Statistical analysis software (SAS) was
used for statistical analysis. Engel classification was used to assess seizure outcome.
Results
Fifteen subjects had resective surgery. Fourteen had palliative surgery with vagal
nerve stimulator (VNS) insertion (13) and corpus callosotomy (1). Of the 29 subjects,
35% had class I outcome (all in the resective group). When combining all subjects
(resective and palliative), 66% of subjects benefited with class I–III outcomes. In
the total cohort, age at time of surgery was significant, with class I outcome more
frequently seen in the younger age group when compared with classes II–IV (p = 0.01).
Conclusion
A subset of children with ASD can benefit from resective surgery, and for those who
are not candidates, a VNS can offer significant improvements in seizure control.
Keywords
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Article Info
Publication History
Published online: July 04, 2018
Accepted:
June 14,
2018
Received in revised form:
May 31,
2018
Received:
April 17,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
