Cognitive Outcomes in Children With Temporal Lobe Epilepsy: Predictors of Academic Attainment

Objectives: Children with temporal lobe epilepsy (TLE) are at a significant risk of cognitive disability and academic underachievement. Where medicines have proven ineffective for seizure management, surgical intervention has proven to be valuable treatment; nevertheless, the long-term cognitive and academic outcomes for this group of children are unclear.
Method: Clinical data on 72 children who underwent surgical resection for unilateral TLE were reviewed at around 12-months post-surgery. Pre- versus post-surgery cognitive and achievement assessments were compared to investigate outcomes and the contributions of demographic and epilepsy-related variables.
Results: The findings suggest overall modest improvements in test scores, but with some areas of greater change, including decline in some domains. The picture is dominated, however, by substantial individual variability.
Conclusions: Epilepsy surgery for TLE in childhood does not, in general, have a significant deleterious or positive effect on cognition or academic achievement, in the short-medium term. Marked individual variation is the norm. Research and clinical implications, particularly a need for longitudinal studies, are discussed.