I would like to direct our readers towards an interesting study. This study did very long-term follow-up on children who had surgery to control they’re seizures (Skirrow, Neurology, 2011). They looked at:
- seizure control
- intellectual function (measured by neuropsychological testing before and after surgery)
The study found that epilepsy surgery improved seizure control dramatically and many children were completely seizure-free. Several studies have shown this and this was not unexpected.
Probably the most interesting finding in the study was that intellectual function appeared to improve after the surgery. Isn’t that interesting- brain tissue was removed to control seizures. Even with removing brain tissue, intellectual function improved! IQ scores were noted to improve after greater than 6 years of follow-up. Thus, the improvement was not noted immediately, but rather several years after the surgery.
The most important factor in improving IQ scores after surgery was stopping antiepileptic drugs. I think this is important for patients and doctors to be aware of. In our patient’s who have well controlled seizures after surgery, lowering or stopping medications certainly should be discussed thoroughly.
I thought pointing out the results of this study would be helpful for our readers. This is further evidence that for those who are candidates for epilepsy surgery, the benefits may potentially outweigh the risks. Thus, surgery is not just about improving seizure control. Surgery may also lead to the added benefit of better intellectual function!
The entire article is available on-line (free!):
Skirrow C, et al. Long-term Intellectual Outcome After Temporal Lobe Surgery in Childhood. Neurology 2011;76:1330-1337.
There is also a review of the article in Epilepsy Currents (free on-line!)