Pediatric epilepsy surgery: Neuropsychological and psychosocial outcomes

Intractable epilepsy can have a detrimental impact on children, increasing the likelihood of developmental delays and cognitive dysfunction, and negatively impacting quality of life. The goals of surgical intervention in pediatric epilepsy are multifactorial and include optimal seizure control and/or remission, improvement of functionality, and facilitation of brain development. Several factors contribute to post-surgical outcomes in children, which will be discussed in this article. Research findings suggest that surgical treatment can have a positive effect beyond seizure control, including improvements in cognition, academic skills, neurobehavioral functioning, and emotional state. An important emerging theme in the presented studies is advocacy for early surgical intervention in children. Future expansion of research in long-term pediatric surgery outcomes is necessary, especially regarding epilepsy in posterior brain regions, effect on academic performance, and impact on overall quality of life following surgery. Advances in structural and functional neuroimaging will contribute to greater understanding of the relationship between outcomes and plasticity.