Relative frequency, clinical, neuroimaging, and postsurgical features of pediatric temporal lobe epilepsy

Abstract

We describe the relative frequency, clinical features, neuroimaging and pathological results, and outcome after pharmacological or surgical intervention for a series of pediatric patients with temporal lobe epilepsy (TLE) from an epilepsy center in Brazil. The medical records of children younger than 12 years with features strongly suggestive of TLE were reviewed from January 1999 to June 1999. Selected children were evaluated regarding clinical, EEG, and magnetic resonance imaging (MRI) investigation and divided into three groups according to MRI: group 1 (G1, N = 9), patients with hippocampal atrophy; group 2 (G2, N = 10), patients with normal MRI, and group 3 (G3, N = 12), patients with other specific temporal lesions. A review of 1732 records of children with epilepsy revealed 31 cases with TLE (relative frequency of 1.79%). However, when the investigation was narrowed to cases with intractable seizures that needed video-EEG monitoring (N = 68) or epilepsy surgery (N = 32), the relative frequency of TLE increased to 19.11 (13/68) and 31.25% (10/32), respectively. At the beginning of the study, 25 of 31 patients had a high seizure frequency (80.6%), which declined to 11 of 31 (35.5%) at the conclusion of the study, as a consequence of pharmacological and/or surgical therapy. This improvement in seizure control was significant in G1 (P < 0.05) and G3 (P < 0.01) mainly due to good postsurgical outcome, and was not significant in G2 (P > 0.1, McNemar's test). These results indicate that the relative frequency of TLE in children was low, but increased considerably among cases with pharmacoresistant seizures. Patients with specific lesions were likely to undergo surgery, with good postoperative outcomes. Correspondence

Role of Magnetic Resonance Imaging of Brain in the Evaluation of Paediatric Epilepsy

“…Mesial temporal sclerosis was most commonly seen in 71.4%, followed by Focal cortical dysplasia and Tuberculosis with tuberculoma in 14.3% patient each. Our study correlates with study done by Sales LV et al 8 , in which out of 31 patients with temporal lobe epilepsy, mesial temporal sclerosis was seen in 9 (29.0%), dysplasia in 8 (25.8%), tumors in 2(6.4%), arachnoid cyst in 1 (3.2%) and choroid cyst in 1 (3.2%). In our study, out of 4 patients with mesial temporal sclerosis, hippocampal atrophy and secondary change (dilatation of temporal horn) was found in 100% of patients.…”

Mesial temporal lobe epilepsy: an old and yet not entirely unfold story

“…Although MTLE is frequently reported in pediatric population, almost all published data focus in comparing kids and adults in respect to clinical semiology and surgical outcome. One study that evaluated seizure outcome in surgical and non-surgical children with MTLE comes from Sales et al 11 .…”