Influence Of Intellectual Outcomes In Children With Refractory Epilepsy After Individualized Surgery

Objective : Refractory epilepsy is common and troublesome among neurosurgical diseases.This study is designed to evaluate seizure control and degrees in intellectual outcome in children with refractory epilepsy after surgical treatment.Methods: 27 children with refractory epilepsy were treated with individualized choices of epilepsy surgery.We used the Engel Epilepsy Surgery Outcome Scale to evaluate seizure control and the Wechsler Intelligence Scale for Children,fourth edition(WISC-IV),to test the children's intellectual outcomes 7 days pre-operative and 3,6 and 12 months post-operative.We confirmed intellectual-outcome improvement after surgery by making comparisons of different aspects..Results: We deemed 17 cases seizure free(Engel I)and 5 cases to have suffered few attacks since surgery(Engel II).In 3 cases,the frequency of seizures decreased by more than 90%(Engel III).In the remaining 2 cases,the effects of surgery on seizure control were not obvious(Engel IV).All children completed the WISC-IV test,7 days before the test results: 40 ~ 105(71.63±21.12)points,3 months after the test results: 40.00 ~ 105.00(73.19±21.33)points,6 months after the test results: 41.00 ~ 106.00(75.15± 21.20)points,12 months after the test results: 42.00 ~ 109.00(78.33±21.29)points.Post-operative intelligence quotient(IQ)increased by 2.00~12.00(6.70±2.45)points 12 months post-surgery compared with the results of the pre-operative tests(P<0.001),and There is no significant difference in the cognitive effect between craniotomy and vagus nerve stimulation(P>0.05).Conclusion: Individualized epilepsy surgery is safe and effective for children with refractory epilepsy.It can control or reduce the frequency of post-operative attacks as well as improve post-operative intellectual outcomes to different degrees.