In around 30% of children with epilepsy, seizures are resistant to medication effects. This type of epilepsy, called temporal lobe epilepsy (TLE), is often caused by brain abnormalities, such as tumours. Over time, poor seizure control can lead to a decrease in intellectual functioning.
Temporal lobe surgery is an established treatment that can result in excellent long-term seizure control and has, in recent years, increasingly been performed in children. However, prior to this study, little was known about the long-term outcomes. Researchers have now identified positive cognitive outcomes of surgery including an increase in IQ. These results were published in an article in Neurology, the official journal of the American Academy of Neurology.
The report findings are based on the follow-up of 42 children who underwent the surgery, after an average postoperative period of nine years. A well-matched non-surgical group of 11 children with similar clinical characteristics was also assessed.
At follow-up, 86% of the individuals who had undergone temporal lobe surgery were seizure-free, and 57% were no longer taking antiepileptic medication. A significant increase in IQ was found in the surgical group (a change not found in the comparison group) and they also reported an increase in quality of life, which was more strongly associated with seizure freedom rather than surgery per se.
Dr Torsten Baldeweg, one of the authors of the report explained: “It was very encouraging to find that children who had suffered the greatest cognitive deficits before surgery benefited most from this treatment. We are delighted that this surgery can have such a positive impact on children’s lives, and will continue to investigate the brain changes of children who have undergone epilepsy surgery to further enhance our understanding of their cognitive and educational development.”
Kate, 28, who underwent temporal lobe surgery at Great Ormond Street Hospital when she was 12 years old, had been affected by epileptic fits since she was five. As she got older this affected her independence – she couldn’t go out alone, and after a fit she would feel unwell. Though medication calmed her fits down, it wasn’t stopping her from fitting.
Following surgery Kate was able to dramatically reduce her medication. “The surgery transformed my life and gave me independence as an adult that I wouldn’t have had otherwise. I’m able to drive, went to university, and even went travelling on my own for six months.”
Great Ormond Street Hospital Children’s Charity’s Theatres for Theatres Appeal has raised vital funds towards two new state-of-the-art operating theatres at Great Ormond Street Hospital for children who require specialist neurosurgery.