Academic achievement one year after resective epilepsy surgery in children

Few studies have examined the academic functioning of children following pediatric epilepsy surgery. Although intellectual functioning has been more thoroughly investigated, children with epilepsy may experience additional difficulties with academic skills. This study examined the academic outcomes of a cohort of children who underwent pediatric epilepsy surgery on an average 1.2 (standard deviation [SD]: 0.3) years prior.

Participants were 136 children (mean age: 14.3 years, [SD]: 3.7 years) who had undergone resective epilepsy surgery. Academic functioning was assessed presurgery and postsurgery using standardized tests of reading, reading comprehension, arithmetic, and spelling.

At baseline, 65% of the children displayed low achievement (1 SD below test mean), and 28% had underachievement (1 SD below baseline IQ) in at least one academic domain. Examining change over time revealed that reading, numeral operations, and spelling significantly declined among all patients; seizure freedom at follow-up (attained in 64% of the patients) did not influence this relationship. Reading comprehension and IQ remained unchanged. Similar findings were found when examining patients with a baseline IQ of ≥ 70 and when controlling for IQ. Regression analyses revealed that after controlling for IQ, demographic and seizure-related variables were not significantly associated with academic achievement at follow-up.

Results show baseline academic difficulties and deteriorations following surgery that go beyond IQ. Further investigations are required to determine whether the observed deteriorations result from the development of the child, the course of the disorder, or the epilepsy surgery itself. Long-term studies are warranted to identify the progression of academic achievement and whether the observed deteriorations represent a temporal disruption in function.