Children Who Undergo Epilepsy Surgery May Struggle Academically

Although brain surgery is a common option for patients with epilepsy who do not respond to medication, a recent study has found that children who undergo this procedure may experience difficulties in school afterward. The study, published in Epilepsy & Behavior, examined the arithmetic, spelling, and reading comprehension abilities of 136 children aged 5 to 18 years who had undergone resective epilepsy surgery—a procedure that removes a part of the brain in order to reduce seizures—between 1995 and 2013. All of the participants had completed standardized tests before and 14 months after the surgery, with many of the children underachieving in at least one area on the presurgery evaluation; this was consistent with previous findings in which children with epilepsy were determined to be at higher risk of having cognitive problems in areas such as language, problem solving, learning, and memory.

Most of the children fared even worse on the post- surgery test, with many participants’ scores in reading, spelling, and numeral operations dropping 2 to 10 points. This suggests that although brain surgery may successfully stop seizures, it will not necessarily improve the academic performance of patients with epilepsy, according to the study authors.

“The surgery stops the seizures, but it’s not like we put a new brain in there. These children still have a preexisting brain abnormality,” said lead author Mary Lou Smith, a psychology professor at the University of Toronto, in a press release.

“What I think is happening now is as they’re getting older, they’re not progressing at the same rate their peers are progressing, and so as a result of that, over time, you see these lower scores because the difference between their performance and what’s expected given their increasing age is widening,” Smith added.

The study authors acknowledged that they cannot yet determine if the lower test results were due to the surgery, the epilepsy, or the children’s development, but noted that their findings may help the families of patients with epilepsy decide whether surgery is the best choice for their child.

“This is a tremendously challenging decision for parents, and they want to know the risks and benefits,” Smith stated. “I think this information is very important for health care providers if they’re counseling patients and for pursuing evidence-based practice.”