Do behavior and emotions improve after pediatric epilepsy surgery? A systematic review

Area of Science:

• Pediatric Neurology
• Neurosurgery
• Child Psychology

Background:

• Pediatric epilepsy surgery aims to improve seizure control and quality of life.
• Behavioral and emotional functioning are critical aspects of a child's well-being post-surgery.
• Systematic review of existing literature is needed to consolidate findings on post-surgical behavioral and emotional outcomes.

Purpose of the Study:

• To systematically review studies on behavioral and emotional functioning in children before and after epilepsy surgery.
• To identify changes in behavior and emotions, associated factors, and the impact of study quality.

Main Methods:

• Systematic review conducted following PRISMA guidelines.
• Searched PubMed and EMBASE databases.
• Analyzed findings based on changes between baseline and follow-up, associated factors, and study quality.

Main Results:

• Fifteen studies were included; most used parent-report screening checklists.
• Seven studies showed significant improvements in at least one domain on screening measures; two showed no significant change.
• No studies reported behavioral deterioration; clinical diagnoses showed no significant change in numbers, though some children lost/gained diagnoses. Better seizure outcomes correlated with improved functioning.

Conclusions:

• Evidence suggests some improvement in emotional and behavioral functioning post-pediatric epilepsy surgery, primarily on parent-reported screening measures.
• Improvements are not consistently reflected in clinical diagnoses.
• Future research requires multi-respondent data, diagnostic interviews, long-term follow-up, and control groups for robust understanding.