The clinical neuropsychologist and head of the School of Psychological Sciences at the University of Melbourne discussed the early-stage research into neurorehabilitation post-epilepsy surgery, and the promise it might hold to address surgery’s long-term risks.
“We know that immediately after the surgery, the dynamic changes taking place in the brain and the recovery process that’s going on—which is understood in the context of neuroplasticity—means that we don’t always get a reliable or accurate picture early post-surgery. We need to do assessments longitudinally and we need to look over the longer term, which might be 5 or more years after surgery.”
When patients with epilepsy are refractory to antiepileptic therapy, there are several options for physicians and their patients to take, one of which is resective surgery. Of those surgeries, the most common is anterior temporal lobectomy, which is where the majority of research into risk factors and challenges has been done.
For Sarah Wilson, PhD, clinical neuropsychologist, and head, School of Psychological Sciences, University of Melbourne, the concern within this group of surgeries is focused on the long-term risks related to memory, and in some patients, language. She noted that immediately post-surgery, the long-term outlook is difficult to judge, and so long-term assessments of these patients need to be made. One of the ways to do this as well as lower the risk of challenges is to utilize neurorehabilitation.
To find out more about these neurorehabilitation methods and what has been done thus far, NeurologyLive spoke with Wilson at the 2019 International Epilepsy Congress, June 22-26, in Bangkok, Thailand. While these are in their early stages, Wilson noted that there has been some interesting work done in neuroplasticity to attempt to discern if the brain can be re-trained, so to speak, to address these issues after surgery.
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Coleman H, McIntosh A, Wilson S. Living with epilepsy: patient perceptions of their epilepsy and its treatment 15 to 20 years after epilepsy surgery. Presented at: 2019 International Epilepsy Congress. June 22-26, 2019; Bangkok, Thailand. P348.