The impact of epilepsy surgery on motor performance of 37 children (ages 1 month to 15 years) with refractory seizures was evaluated at the Wilhelmina University Children's Hospital, Utrecht, The Netherlands. Surgery involved hemispherectomy in 14 patients, and temporal (14), frontal (4), parietal (2), or central (2) resection. Presurgical spasticity was present in 17 (46%). Seizures were significantly reduced in frequency in 74% at 24 month follow-up. Muscle strength and range of motion were decreased, but activities of daily living were improved and need for caregiver's assistance was reduced in the group with spasticity. The movement assessment battery (M-ABC) and gross motor function measure (GMFM) scores were significantly improved (P<0.05). [1]

COMMENT. Motor function of most children undergoing surgery for epilepsy is not impaired, caregiver's assistance is reduced, and activities of daily living are improved.

Cognitive function in preschool children after epilepsy surgery. Age of seizure onset and extent of the lesion were predictive of preoperative cognitive development in 50 patients treated surgically at age 3 to 7 years; 70% were retarded, with IQ <70. At 6 months to 10 years after surgery, 11 showed IQ/DQ gains of >15 IQ points, but only in children free of seizures. Shorter duration of epilepsy was significantly associated with a postoperative increase in DQ. [2]