Indications and expectations for neuropsychological assessment in epilepsy surgery in children and adults: Executive summary of the report of the ILAE Neuropsychology Task Force Diagnostic Methods Commission: 2017-2021
Indications and expectations for neuropsychological assessment in epilepsy surgery in children and adults: Executive summary of the report of the ILAE Neuropsychology Task Force Diagnostic Methods Commission: 2017-2021
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DOI：
10.1111/epi.16309
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发表时间：
2019-09-01
期刊：
影响因子：
5.6
通讯作者：
Smith, Mary-Lou
中科院分区：
文献类型：
--
作者：
Baxendale, Salle;Wilson, Sarah J.;Smith, Mary-Lou
随着时间的推移，神经心理学评估在癫痫手术候选人术前评估中的作用不断发展，现在这是癫痫手术患者术前评估的强制性部分。一个全面的神经心理学评估提供了一个基线，根据该基线可以识别术后功能的变化，并可以管理术后变化的预期。术前评估还有助于癫痫发作的定侧、定位和表征，并提供与拟定手术相关的认知风险的循证预测，包括健忘症风险筛查。基线神经心理学评分应根据所有其他术前评估的结果进行解释，以评价其在基础病理学方面的偏侧或局部意义。许多不同的因素可以联合收割机在神经心理学的轮廓中创造出相同的优势和劣势轮廓。只有当神经心理学测验分数通过患者完整的临床病史和其他研究结果的透镜来解释时，神经心理学轮廓的侧化和定位意义才变得清晰。术前神经心理评估的结果为术前心理咨询提供了依据。这种咨询应包括探索手术的风险、益处和可能的认知成本，以及探索患者和家属对手术治疗的期望。
The role of the neuropsychological assessment in the presurgical evaluation of epilepsy surgery candidates has evolved over time, and this is now a mandatory part of the preoperative evaluation of epilepsy surgery patients. A comprehensive neuropsychological assessment provides a baseline against which changes in postoperative function can be identified and expectations of postoperative change can be managed. The presurgical assessment also contributes to seizure lateralization, localization, and characterization, and provides evidence‐based predictions of cognitive risk associated with the proposed surgery, including screening for amnesic risk. Baseline neuropsychological scores should be interpreted in the light of the results from all of the other presurgical evaluations to evaluate their lateralizing or localizing significance in terms of underlying pathology. Many different factors can combine to create the same profile of strengths and weaknesses within a neuropsychological profile. It is only when the neuropsychological test scores are interpreted through the lens of the full clinical history of the patient and the results of other investigations that the lateralizing and localizing significance of the neuropsychological profile becomes clear. The results from the presurgical neuropsychological assessment create the evidence base for preoperative counseling. This counseling should include explorations of the risks, benefits, and likely cognitive costs of surgery and explorations of patient and family expectations of surgical treatment.