Temporal Lobe Epilepsy in Early Childhood

Abstract

To explore the electroclinical features of temporal lobe epilepsy (TLE) in early childhood, we studied results of video-EEG and other tests of 14 children aged 16 months to 12 years selected by seizure-free outcome after temporal lobectomy. Four children had mesiotemporal sclerosis, 1 had cortical dysplasia, and 9 had low-grade temporal neoplasms. The children had complex partial seizures (CPS) with symptomatology similar to that of adults with TLE, including decreased responsiveness and automatisms. Automatisms tended to be simpler in the younger children, typically limited to lip smacking and fumbling hand gestures. Scalp/sphenoidal EEG showed anterior/inferior temporal interictal sharp waves and unilateral temporal seizure onset in the 4 children with mesiotemporal sclerosis and in the child with cortical dysplasia, but EEG findings in 9 children with low-grade temporal tumors were complex, including multifocal interictal sharp waves or poorly localized or falsely lateralized EEG seizure onset. In children without tumors, video-EEG was critical to localization of the epileptogenic zone for resection, but in patients with tumors video-EEG was less localizing and its main value was to confirm that the reported behaviors were epileptic seizures with semiology typical of temporal lobe onset.

Temporal lobe epilepsy in childhood: review article

“…Mesial temporal sclerosis affects 10 to 20% of children undergoing surgical treatment of TLE in the second half of the first decade of life and is considered rare in children younger than five years of age (8,9,12) ; it is, however, the most frequent etiology in some studies, reaching 70% of the cases of TLE (13) . Magnetic resonance imaging (MRI) detected MTS in 57% of 53 children, two to 17 years of age (mean age of 10 years), which led the authors to claim that this is the most common lesion in children with refractory TLE and that it is underdiagnosed in that age range, delaying surgical procedures (14) .…”

“…Major advances occurred, mostly in the last decade, resulting from several studies with long term video-EEG monitoring in children (7)(8)(9)(10) .…”

“…Pleomorphic xanthoastrocytoma is rare and affects adolescents and young adults (6) . Oligodendrogliomas are infiltrative tumors, which affect children with an incidence of 7-14% (8,9) . Focal cortical dysplasia was originally described in the temporal lobe (27) and is considered by some authors as the most frequent cause of refractory TLE in children (7,28,29) .…”

Tratamento cirúrgico das epilepsias na criança

“…É sobre esses pacientes que trata o presente artigo. O desenvolvimento do tratamento cirúrgi-co das epilepsias passa necessariamente pelos avanços tecnológicos nas últimas duas décadas, e mais notadamente nos últimos anos; conseqüentemente, tem havido um núme-ro crescente de centros dedicados ao tratamento cirúrgico da epilepsia em crianças [1][2][3][4][5][6][7][8][9][10] . Esse crescente interesse devese a pelo menos dois fatores: os bons resultados na maioria dos pacientes, e a introdução de novas técnicas de investi-gação, especialmente de neuroimagem 11 .…”

Interictal electroencephalographic findings in children and adults with temporal lobe tumors

“…The growth of those tumors and their pathological findings suggest that they, particularly gangli-ogliomas and DNET, might either originate from a c o rtical malformation or be the final end of the spect rum of the cortical dysplasias 5 -9 . In children with TLE of diff e rent etiologies there is a wide clinico-electroencephalographic diversity 2,[10][11][12][13] . Knowing that tumoral lesions lead to a variable e l e c t roencephalographic pattern, particularly in child ren, we aimed to compare interictal EEG findings of children with those of adults with TLE due to tumoral lesions.…”