The Role of Inpatient Rehabilitation After Pediatric Epilepsy Surgery for Refractory Epilepsy

Abstract

Epilepsy surgery reduces seizure burden and antiepileptic use while improving quality of life. Neuroplasticity and rehabilitation aid in recovery after epilepsy surgery. We aimed to examine the impact and role of inpatient rehabilitation after epilepsy surgery in pediatric patients with refractory epilepsy. A retrospective chart review examined patients aged 0–18 years old undergoing epilepsy surgery for refractory epilepsy at our institution between 2012 and 2018, with subsequent admission to inpatient rehabilitation. Demographic, clinical, neurocognitive, and functional outcomes were measured. Thirty-six patients were included: 17 male (47.2%) and 19 female (52.8%). Mean age was 9.3 years (SD 5.2, range 1.1–18.9). The most common procedures were hemispherectomy (13, 36.1%) and lobectomy (12, 33.3%). The mean duration of rehabilitation was 16.2 days (SD 9.2, range 6–42). WeeFIMR scores improved after rehabilitation (65.6 vs. 49.3, p 0.05), and procedure type (p < 0.02), with more independent patients undergoing lobectomy compared with hemispherectomy. Admission and discharge WeeFIMR scores were higher in those functionally independent compared with those functionally dependent at last follow-up (p < 0.01 for all subscores). No difference in change in WeeFIMR was seen between those functionally independent vs. dependent at last follow-up (p < 0.11). Postoperative inpatient rehabilitation after pediatric epilepsy surgery is associated with functional improvement in self-care, mobility, and cognition, but may be influenced by age or procedure type.