Long-Term Cognitive Outcomes After Epilepsy Surgery in Children

Here we examine the evidence for long-term changes in cognitive functions after epilepsy surgery in studies published mostly since 2010. Specifically, we looked for evidence of developmental “catch-up” as indicated by an increase in IQ scores in comparison with preoperative values. About half of the studies report significant increase in IQ scores in the surgical group over time or in comparison with a nonsurgical control group. Better cognitive outcomes are linked to greater overall level of seizure freedom and partially to medication reduction. When taking into account the large variability in sample sizes and seizure freedom between studies, a modest correlation of improved cognitive outcomes with longer follow-up duration can be observed. Further research is urgently needed which relates preoperative cognitive changes with postoperative development and identifies clinical and educational factors which facilitate cognitive outcomes after epilepsy surgery in children.