A Systematic Review of Total IQ Changes After Epilepsy Surgery in Children and Adolescents
Abstract number :
3.323
Submission category :
9. Surgery / 9B. Pediatrics
Year :
2022
Submission ID :
2204748
Source :
www.aesnet.org
Presentation date :
12/5/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:26 AM
Authors :
Johanna Wagner, Dr. med. – Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Dr. von Hauner Children's Hospital, Department of Pediatrics and Epilepsy Center for Children and Adolescents, Ludwig-Maximilians-University; Tristan Schmidlechner, student – Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Dr. von Hauner Children's Hospital, Department of Pediatrics and Epilepsy Center for Children and Adolescents, Ludwig-Maximilians-University; Sonia Cornell, Dr. rer. nat., psychologist – Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Dr. von Hauner Children's Hospital, Department of Pediatrics and Epilepsy Center for Children and Adolescents, Ludwig-Maximilians-University; Ingo Borggraefe, Prof. Dr., Head, Pediatric Epilepsy Center for Children and Adolescents, Ludwig-Maximilians-University – Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Dr. von Hauner Children's Hospital, Department of Pediatrics and Epilepsy Center for Children and Adolescents, Ludwig-Maximilians-University
Rationale: This systematic review aimed to assess the cognitive outcome of children who underwent surgical treatment for epilepsy.
Methods: We conducted a systematic literature review following PRISMA guidelines searching electronic databases of Medline on December 3, 2021, and Web of Science on January 11, 2022. Advanced search terms were used. Included studies reported on full-scale intelligence quotient (FSIQ) or developmental quotient (DQ) before and after neurosurgical treatment of epilepsy in children. Studies were defined eligible if the majority of the population was younger than 18 years of age. We included respective and disconnective procedures (except callosotomy). Other procedures intending a less curative approach as VNS, ATS and multiple subpial transection were excluded.
Results: The search yielded 1119 manuscripts. 57 Studies reporting on a total of 2591 patients fulfilled inclusion criteria. Mean age (+/- SE) at surgery was 9,19 +/- 0,48 years. Overall, 41 studies reported on FSIQ changes. Improvement of FSIQ was seen in 31 studies (9 studies revealed FSIQ worsening and 3 studies no IQ change). Pooled analysis revealed a significant mean gain in FSIQ (+/- SE) of 2,68 +/- 0,67 (p < 0.001). Delta FSIQ changes were significantly higher in seizure free patients than in non-seizure free patients (4,91+/- 1,85 vs. 0,43 +/-1,64, respectively, p=0,043). Controlled studies showed better outcome in the surgery group compared to the non-surgery group. FSIQ outcome did not significantly correlate with age at surgical intervention, duration of epilepsy or preoperative IQ. Improvement of FSIQ was only seen in long-term follow up in some studies.
Surgery