Objective: Identifying lateralized cerebral dysfunction is a goal of neuropsychology when children are considered for epilepsy surgery. Motor laterality and VIQ/PIQ discrepancies are among the comparisons used for this purpose, but little information is known about the frequency of lateralized findings in these scores. The current study was conducted to investigate the frequency and degree of motor and verbal/performance discrepancies in children with partial seizures. Data Selection: Our sample consisted of 129 children with partial epilepsy who were referred for testing at a tertiary care epilepsy center. The children ranged in age from 5–15 years (M = 10.68; SD = 3), and they were predominantly male (54.7%). All children had a seizure focus that was lateralized to only one cerebral hemisphere, as determined by epileptologists. Data Synthesis: Finger tapping identified seizure focus in 45% of children. Grooved pegboard lateralized 44% of children. Motor tasks were particularly effective in right-handed patients with right-sided seizures (62-90%). Lateralization was modest in left-handed children with left-sided seizures (58%), and it was poor in the remainder of the sample. VIQ/PIQ discrepancies revealed only modest variation from expected base-rates. However, 40% of left-handed children with left-sided seizures demonstrated a significant difference. Conclusion: Our study suggests limited utility in using motor tasks and VIQ/PIQ discrepancies to lateralize seizures in children. Motor tasks are only sensitive in one subgroup, suggesting poor specificity in general. VIQ/PIQ discrepancy failed to demonstrate sensitivity across all seizure groups and only appeared effective in left-handed children with left-sided seizure. Implications of these findings to the clinical management of children with epilepsy will be discussed.
The Utility of Motor Tasks and Intelligence Scores in Lateralizing Seizure Focus in Children with Epilepsy
J Schwartz, S Kaur, J Titus; B-77
The Utility of Motor Tasks and Intelligence Scores in Lateralizing Seizure Focus in Children with Epilepsy. Arch Clin Neuropsychol 2015; 30 (6): 551. doi: 10.1093/arclin/acv047.172
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