Variable Long-Term Cognitive Changes in Pediatric Epilepsy

Girl hooked up to EEG machine
Children with pediatric epilepsy who undergo surgery may experience long-term changes in verbal and nonverbal IQ.

Children with pediatric epilepsy who undergo surgery may experience changes in verbal and nonverbal IQ, particularly when associated with abnormal electroencephalogram (EEG), according to research presented at the 2019 American Epilepsy Society Annual Meeting, held December 6-10, 2019, in Baltimore, Maryland.

Researchers sought to assess the long-term, postsurgery cognitive outcomes of patients with pediatric epilepsy. Investigators assessed 24 participants, all of whom had pharmacoresistant epilepsy. Participants underwent a neuropsychological evaluation that included intellectual functioning assessments (overall IQ, verbal IQ, and nonverbal IQ), as well as an evaluation of postsurgical seizure status.

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The mean time to postsurgical evaluation was 4.57±1.62 years. At the time of evaluation, researchers classified patients as Engel I, Engel II, or Engel III (n = 17, 4, and 3, respectively). No significant changes in full scale or nonverbal IQ were noted. Verbal IQ decreased significantly between the pre- and postsurgical neuropsychologic evaluations.

In terms of EEG status, results demonstrated a significant between-group difference for nonverbal IQ. Both children and adolescents with abnormal EEG at follow up demonstrated greater deficits in nonverbal skills measurements compared with children with normal/slow EEG.

“Few studies investigate the long-term cognitive outcomes of children and adolescents with epilepsy who undergo surgical intervention,” the researchers concluded. “Here, we provide evidence that while overall intellectual function remains stable in most participants, verbal IQ and nonverbal IQ may be differentially affected.…With more systematic long-term follow-up assessment, additional variables such as seizure status, surgical location, and neuroimaging variables may further explain variance in outcome.”


Trapani J, Thompson MD, Goyal, M, et al. Long-term cognitive outcomes and EEG status after surgery in pediatric epilepsy. Presented at: American Epilepsy Society 2019 Annual Meeting; December 6-10, 2019; Baltimore, MD. Abstract 2.328.