IQ changes after pediatric epilepsy surgery: a systematic review and meta-analysis

Area of Science:

• Pediatric Neurology
• Neurosurgery
• Developmental Psychology

Background:

• Medically intractable epilepsy in children significantly impacts cognitive development.
• Assessing the intellectual outcomes following epilepsy surgery is crucial for treatment planning and prognosis.

Approach:

• A systematic review and random-effects meta-analysis of 57 studies involving 2593 children.
• Included studies reported intelligence quotient (IQ) or developmental quotient (DQ) changes pre- and post-surgery for medically intractable epilepsy.
• PRISMA guidelines were followed, with data searched from PubMed and Web of Science.

Key Points:

• A pooled analysis revealed a significant mean gain of +2.52 Full Scale IQ (FSIQ) points.
• Higher FSIQ gains were observed in children who achieved seizure freedom (+5.58) and those who discontinued anti-seizure medications (+6.37).
• Controlled studies indicated better outcomes in the surgical group compared to non-surgical controls.

Conclusions:

• Epilepsy surgery in children with intractable epilepsy is associated with a mean gain in FSIQ and DQ.
• The observed FSIQ gain suggests stabilization of intellectual function, with greater improvements in seizure-free and medication-free patients.
• Further research is needed to understand individual changes and long-term effects of specific surgical interventions.