| Pediatric epilepsy is one of the most common childhood diseases. While the majority of children experience seizure freedom with anti-epileptic medication, approximately 20-25% has recurrent seizures, which can lead to neurological abnormalities. Thus, there are consequences of intractable seizures that reach beyond physical health, and have implications for real-world functional deficits as a consequence of altered brain development. The central hypothesis of this thesis is that recurrent seizures will result in brain hemisphere and lobe asymmetry reflecting increased volume on the contralateral hemisphere. Secondary hypotheses investigate the impact of age of seizure-onset on hemisphere and lobe volumes, and aberrant hemisphere and lobe development on neuropsychological function.;A retrospective chart-review was performed with 21 pre-surgical temporal lobe seizure-onset patients, ranging from 2 to 17 years. Magnetic Resonance Imaging (MRI) and neuropsychological data (WISC-III Block Design and Vocabulary subtests and CVLT) were obtained. From MRI, brain hemisphere and lobe volumes were extracted and combined in SPSS with demographic and neuropsychological chart data. Paired T-test did not reveal significant asymmetry between ipsilateral and contralateral hemisphere and lobes. However, earlier age of seizure-onset was associated with increased ipsilateral hemisphere and frontal lobe volumes, and decreased bilateral parietal lobe volumes. There was a positive association with bilateral temporal lobe volume and nonverbal and verbal estimates of intelligence.;The findings suggest that younger age of seizure-onset may lead to compensatory brain development in select brain regions, supporting the plasticity -- crowding hypothesis. Further studies looking at the causal relationship can help identify critical seizure-onset periods, which will inform treatments that can improve the quality of life for children having focal epilepsies. |
