Impact of Epilepsy Surgery On Developmental Trajectories In Drug-Resistant Epilepsy Children Under 3 Years of Age

INTRODUCTION Despite the significance of early intervention, the impact of epilepsy surgery on development is still not predictable. We aim to investigate the developmental effects of epilepsy surgery in young children. METHODS This study retrospectively reviewed 315 consecutive children under 3 years of age, and ultimately included 89 children with pre- and post- surgery developmental evaluations with a uniform standardized test(Griffiths Developmental Scales- Chinese edition). RESULTS The mean general quotient (GQ) before surgery was 46.7 (24.7). Prior to surgery, GQ decreased in 77.6% of patients, while after surgery, GQ increased in 55.1% of patients. Furthermore, 70% of those 20 patients whose pre-surgical GQ decreased by more than 10 points experienced positive changes. Among those patients with a normal/marginal pre-surgical category, a decrease in GQ scores was observed in 15 out of 22 cases. Children who underwent surgery before the age of twelve months had a median gain of GQ score by 7.6. Short-term GQ scores were highly correlated with long-term scores (r=0.909, p＜0.001). CONCLUSION Surgical intervention was more inclined to positively impact developmental trajectories within a short post-surgical period, particularly among those affected by severe epileptic activity. However, in children with relatively typical development, certain developmental setbacks may arise. Post-surgical short-term developmental outcomes could predict longer-term outcomes.