Not necessarily true about prolonged seizures being the only factor in taking a toll.
If they were not giving him medication and the seizures were not under control, he could have had impairment. If he had periods of no medication and seizures, he could be at greater risk for cognitive impairment.
http://www.scielo.br/pdf/jped/v86n5/en_v86n5a05.pdf ----which states, "There is evidence supporting the idea that patients with refractory epilepsy have greater intellectual disabilities than medically controlled patients and the general population.10 Our findings indicated that the mean IQ, verbal IQ and performance IQ were significantly higher in the medically controlled group when compared to the medically uncontrolled group. Engelberts et al.7 have previously investigated cognitive performance in patients with chronic well-controlled epilepsy and healthy controls and did not observe deficits in selective attention, memory and executive functions when comparing both groups."
I hope I'm not being confrontational as I sincerely do not mean to be...
"Patients with refractory epilepsy" means patients with seizures that are unaffected, or "not helped" by medications. If a patient is "refractory" to a treatment or in this case anti seizure medication the fact the family failed to medicate the child is meaningless... because by definition refractory means the medication doesn't work, I.e no damage could be done because they were withholding a meaningless medication
In medicine, refractory describes a disease or condition which does not respond to attempted forms of treatment. A cancer is said to be refractory when it does not respond to (or is resistant to) cancer treatment. Refractory cancer is also known as resistant cancer.
If you are a hypertensive patient refractory to antihypertensive medications that is to say you have high blood pressure and blood pressure medications do not work.
It should also be mentioned that a low verbal IQ or General IQ does not mean a patient fails to recognize the difference between right and/or wrong.
You could be a slow person or considered mentally challenged yet still differentiate right and wrong.
This is why I specifically mentioned the frontal lobe or the seizures affecting the frontal lobe as it is considered our emotional control center and home to our personality. There is no other part of the brain where lesions can cause such a wide variety of symptoms (Kolb & Wishaw, 1990). The frontal lobes are involved in motor function, problem solving, spontaneity, memory, language, initiation, judgement, impulse control, and social and sexual behavior. The frontal lobes are extremely vulnerable to injury due to their location at the front of the cranium, proximity to the sphenoid wing and their large size. MRI studies have shown that the frontal area is the most common region of injury following mild to moderate traumatic brain injury (Levin et al., 1987).
