Do children with drug resistant epilepsy and low IQ also improve after epilepsy Ssrgery?

Purpose: To evaluate prospectively pre- and postoperative neuropsychological performance of children with temporal lobe epilepsy (TLE) and low IQ (≤85) compared to those with IQ >85.

Methods: IQ, concentration, flexibility in thinking, and verbal/non-verbal memory were assessed before, 3 months and once/year after surgery (a.s.). Group and individual changes as well as outcome-predictors were evaluated.

Results: 19 patients with low IQ (6–18 years; 12 right TLE) and 22 age-matched patients with average range intelligence (10 right TLE) were included. 3 months a.s., significantly improved verbal (V-IQ), performance (P-IQ), and full scale IQs (FS-IQ) were identified in low-IQ patients whereas patients with average-range intelligence tend to worsen in their V-IQ. 1 year a.s., improvement of V-IQ, P-IQ and FS-IQ was observed in the whole group. Long-term outcome data (2–6 years a.s.) for 20 children also showed significant improvement in P-IQ and FS-IQ for both groups. Data of individual changes corroborat these findings. Concentration improved for both groups (especially for the low IQ-patients) 3 months a.s. and 1 year a.s. Long term verbal memory outcome showed a significant improvement in both groups, especially for the left TLE. IQ-groups did not differ significantly in age at seizure onset and duration of epilepsy.

Conclusion: Due to our results, epilepsy surgery and surgical intervention is advisable in children with low cognitive function.