Intellectual outcome after a cortical lesion with versus without epilepsy: A life span neurodevelopmental view

In patients with cortical lesions, the structure of intelligence has never been studied as a function of age at lesion onset and presence vs absence of lesional epilepsy over the life span.

Two thousand one hundred eighty-six cases were assembled bearing unilateral cortical lesions occurring at all ages (1301 with seizures) with postlesion verbal intelligence quotient (IQ) (VIQ) and performance IQ (PIQ).

Global IQ significantly and constantly decreased as a function of age at lesion onset in the cases without epilepsy, and increased in the cases with epilepsy. Beyond the lesion onset age of 12 years, VIQ was significantly higher than PIQ in the cases without epilepsy, and lower in the cases with epilepsy. The VIQ/PIQ × lesion-side interaction indicative of hemispheric specialization increased significantly linearly with age at lesion onset in the patients without epilepsy but ceased to progress at the lesion-onset age of 30 years and beyond in the cases with epilepsy.

Postlesion global IQ, the difference between VIQ and PIQ, and the laterality index all vary significantly as a function of age at lesion onset. In addition, these changes over the life span are all quite different between cases with and without epilepsy.