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.

KEYWORDS:

• Rasmussen encephalitis
• hemispherectomy
• seizure
• outcome

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed here.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by grants from the Beijing Postdoctoral Research Foundation [2020-ZZ-006]; Project funded by China Postdoctoral Science Foundation [2020M680608]; National Natural Science Foundation of China [81790654, 81790650], Capital Health Research and Development of Special (2016-1-8012).