ABSTRACT
The effect of extratemporal and temporal lobe cortical resection on children with intractable epilepsy is not well understood. We evaluated a comprehensive array of outcome variables in 33 consecutive children who received epilepsy surgery at 12 years of age or younger. Twenty-two (67%) children were seizure-free, three (9%) had a greater than 90% reduction in seizures, and four had no improvement. Antiepileptic drugs (AEDs) were not required in 10 (30%) children and were reduced in number in another 10. Six (29%) of 21 tested children had an improvement of greater than 10 points in Verbal or Performance IQ after surgery, while one (4%) had a decrease greater than 10 points in Verbal IQ. One mild hemiparesis and one inferior quadrantanopsia occurred; both were anticipated. We used the Child Health Questionnaire (CHQ), a valid and reliable instrument for children, to assess health-related quality of life (HRQOL). Six of 12 subscale scores of the CHQ were significantly lower in the surgical group compared with 410 age-matched control subjects. Parents were satisfied with surgical results in 28 (85%) cases. Pathologic tissue diagnosis and site of resection were not associated significantly with any outcome measure. We conclude that surgery eliminates seizures and reduces AED requirements in most children with intractable epilepsy selected by currently available methods. Further investigation is needed to establish the nature and significance of inferior scores in the surgical group in the HRQOL domains of physical function, general health, and self-esteem.
Subject(s)
Epilepsy/surgery , Adolescent , Anticonvulsants/therapeutic use , Child , Child, Preschool , Epilepsy/physiopathology , Epilepsy/psychology , Female , Humans , Intelligence , Male , Morbidity , Neuropsychological Tests , Postoperative Complications , Quality of Life , Treatment OutcomeABSTRACT
This study provides information on the interrater reliability of the quantitative scoring system of the Luria-Nebraska Neuropsychological Battery Form II (LNNB-II). The accuracy of each rater following a training procedure was also evaluated. Six college students served as raters, and participated in a 20-22-hour training procedure. This training procedure utilized a protocol similar to one used in previous interrater reliability studies performed with Form I. Following the training procedure, raters were asked to score two videotaped LNNB-II administrations in which a confederate portrayed test performance that was relatively straightforward to score, as well as more ambiguous test performance. Excellent interrater agreement and accuracy were found on the quantitative scoring on both tapes. Implications for training in administration and scoring are discussed.
ABSTRACT
Nonsuicidal and suicidal adolescent inpatients were compared to community high school students using behavioral measures of impulsivity. Measures of problem solving ability, hopelessness, and depression were also administered to all groups. The suicidal inpatients were characterized by greater impulsivity, hopelessness, and depression than both nonsuicidal inpatients and community high school students. There were no differences in problem-solving abilities found between the suicidal inpatients and either the nonsuicidal inpatients or the community controls.
Subject(s)
Depressive Disorder/diagnosis , Impulsive Behavior/psychology , Suicide Prevention , Adolescent , Age Factors , Depressive Disorder/complications , Depressive Disorder/psychology , Female , Hospitalization , Hospitals, Psychiatric , Humans , Male , Mental Disorders/complications , Mental Disorders/rehabilitation , Problem Solving , Psychiatric Status Rating Scales , Risk Factors , Students/psychology , Surveys and QuestionnairesABSTRACT
The findings of previous studies examining the neurocognitive development of children with clinically inapparent (asymptomatic) cytomegalovirus (CMV) infection have demonstrated mixed results. These studies have generally depended on small sample sizes (i.e., < 50). We examined the intellectual development of children with asymptomatic congenital CMV infection using a sample larger than previous studies. Two hundred and four cases aged 5 to 200 months were compared with 177 uninfected siblings ranging in age from 6 to 203 months. Parents were administered the Developmental Profile, a measure of developmental achievement. Children who were older than 30 months were administered an objective intelligence measure. Results of this study showed that children with asymptomatic congenital CMV infection do not demonstrate intellectual impairment, and that they perform similarly to uninfected siblings. Parents tended to overestimate their child's level of functioning regardless of whether the child had CMV infection.
Subject(s)
Child Development , Cytomegalovirus Infections/congenital , Intelligence , Age Factors , Case-Control Studies , Child , Child, Preschool , Cross-Sectional Studies , Cytomegalovirus Infections/classification , Cytomegalovirus Infections/complications , Female , Humans , Infant , Intelligence Tests/standards , Intelligence Tests/statistics & numerical data , Male , Nuclear Family , Reproducibility of ResultsABSTRACT
This study examined the life stress and problem-solving interactional model of suicide proposed by Clum, Patsiokas, and Luscomb (1979). Thirty-three hospitalized suicidal adolescents were compared with 21 adolescents hospitalized for other psychiatric problems and with 89 controls. The assessment battery was composed of psychological measures, problem-solving measures, and environmental and family measures. The discriminant analyses revealed that the suicide group could be discriminated from the psychiatric control group but not from the high school control group. Unexpectedly, life stresses did not contribute to the identification of current suicide risk. The results suggest the importance of assessing suicide risk at the time of admission to minimize any subsequent changes in the risk group.