The influencing factors and changes of cognitive function within 40 Rasmussen encephalitis patients that received a hemispherectomy.

Abstract

OBJECTIVE:

To evaluate the influencing factors and cognitive functional changes in Rasmussen encephalitis (RE) patients who received a hemispherectomy.

METHODS:

Forty RE patients underwent a hemispherectomy with at least a 2 years follow- up were included in this study . Postoperative seizure outcomes were evaluated according to the Engle classification scale. Univariate analysis and a multivariate logistic regression model in a backward fashion were used to identify the potential predictors of cognitive function.

RESULTS:

All 40 patients had an Engle classification outcome at a 2 years follow-up. Univariate and multivariate analyses revealed that seizure duration (OR 10.06, 95% CI 1.54-3.85, p = 0.038), age at surgery (OR 3.06, 95% CI 1.21-3.56, p = 0.043), and MRI score (OR 0.09, 95% CI 0.01-0.67 p = 0.024) are associated with postoperative cognitive outcomes respectively. Moreover,  VIQ and PIQ were negatively correlated linearly with duration of seizures and MRI score. Patients with a good VIQ and PIQ before the operation were more likely to have a better VIQ and PIQ postoperatively (p < 0.001 and p < 0.001, respectively). And, operation side is an important factor affecting cognitive function; therefore, a left hemispherectomy has a greater impact on the patient's IQ and language.

CONCLUSIONS:

RE patients' cognitive dysfunctions are improved after a hemispherectomy. Right-side operation can achieve better postoperative cognitive outcomes especially in VIQ and language. A shorter duration of seizures, early age at surgery, and less severe brain atrophy suggest better cognitive outcomes after a hemispherectomy.

• Authors: Dong Liu, Yuguang Guan, Jian Zhou, Feng Zhai, Lingling Chen, Tianfu Li, Mengyang Wang, Guoming Luan
• Journal: Neurological research (Neurol Res) Vol. 44 Issue 8 Pg. 700-707 (Aug 2022) ISSN: 1743-1328 [Electronic] England
• PMID: 35172696 (Publication Type: Journal Article)

Topics

• Age Factors
• Cognition
• Cognitive Dysfunction (complications, pathology, surgery)
• Encephalitis (complications, pathology, surgery)
• Follow-Up Studies
• Hemispherectomy (adverse effects)
• Humans
• Inflammation (complications, pathology, surgery)
• Multivariate Analysis
• Seizures (complications, surgery)
• Treatment Outcome