Neuropsychological Outcomes of Memory Functioning in Paediatric Epilepsy Surgery

Abstract

This thesis aimed to explore neuropsychological memory outcomes in children with epilepsy and children who have undergone paediatric epilepsy surgery, comprising a systematic review, an empirical study and a critical appraisal. The systematic review presents a narrative synthesis of the existing literature that explores memory outcomes on standardised neuropsychological assessments in children with Temporal Lobe Epilepsy (TLE). Seventeen studies were identified for inclusion. All studies underwent quality assessment and the methodological quality and evidence derived from the studies were heterogeneous. Clinical implications and future directions were discussed. The review highlighted that children with TLE have poorer memory functioning when compared to typically developing children. The second section of the thesis is an empirical study exploring memory functioning preoperatively and postoperatively in 191 children with epilepsy. Routine clinical data and neuropsychological outcomes on the Children's Memory Scale (CMS) were obtained from participating hospitals. Preoperatively, memory outcomes did not differ between children with TLE and children with frontal or parietal lobe epilepsy (FPE). An increase in the number of Anti-Seizure Medication's (ASM) and earlier seizure onset were associated with poorer memory outcomes. In children who underwent surgical intervention, children with FPE had significant improvements in visual immediate memory and children with TLE showed significant declines in verbal immediate memory. The findings, methodological strengths and limitations, suggestions for future research and clinical implications are discussed. Paper 3 presents a critical appraisal of conducting the thesis, specifically focusing on conducting research within the area of paediatric epilepsy. The strengths and limitations of the systematic review and empirical study are discussed, with personal reflections and clinical implications of findings also presented.

Date of Award	31 Dec 2023
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Anja Wittkowski (Supervisor) & Rebecca Bromley (Supervisor)