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Temporal lobe epilepsy surgery in children and adolescents: clinical characteristics and post-surgical outcome.
Terra-Bustamante, Vera Cristina; Inuzuca, Luciana M; Fernandes, Regina M F; Funayama, Sandra; Escorsi-Rosset, Sara; Wichert-Ana, Lauro; Santos, Antonio C; Araujo, David; Machado, Helio R; Sakamoto, Americo C.
Afiliação
  • Terra-Bustamante VC; Department of Neurology, Hospital das Clinicas, Av Bandeirantes, 3900 Monte Alegre, Brazil. vctbusta@rnp.fmrp.usp.br
Seizure ; 14(4): 274-81, 2005 Jun.
Article em En | MEDLINE | ID: mdl-15911363
BACKGROUND AND PURPOSE: Temporal lobe epilepsy (TLE) encompasses 10-20% of the cases of intractable epilepsy in pediatric patients. Mesial temporal sclerosis (MTS) can still be encountered in adolescent patients, but is rare in children under 5 years of age. In this paper we report on the surgical outcome of a series of TLE patients ranging in age from 1 to 18 years at the time of operation. PATIENTS AND METHODS: Thirty-five patients (37 surgeries) with medically intractable TLE were operated upon between January 1996 and December 2002. The following variables were analyzed: age at surgery, age at epilepsy onset, history of an initial precipitating injury, etiology, seizure semiology, interictal and ictal EEG findings, surgical complications, and post-surgical seizure outcome. RESULTS: There were 68.6% females and 31.3% males, and complex partial seizures (CPS) occurred in 86.5%. The most common etiology was MTS (40%) followed by isolated cortical developmental abnormalities (22.9%). In the age group up to 5 years, cortical development abnormalities predominated, and 71% of these children had multifocal interictal EEG. Patients older than 10 years had more frequently MTS (78.6%) and focal temporal interictal EEG abnormalities. Post-surgical seizure outcome showed that 88.5% of patients were in Engel classes I and II. CONCLUSIONS: Adolescents with TLE had clinical features, electrographic findings, and seizure outcome similar to those observed in adult patients. However, younger children up to 5 years of age had distinct ictal semiology and different etiological, electrophysiological and outcome profiles, clearly suggesting that they behave as a special subgroup within the TLE.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Resultado do Tratamento / Epilepsia do Lobo Temporal / Neurocirurgia Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: Seizure Assunto da revista: NEUROLOGIA Ano de publicação: 2005 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Resultado do Tratamento / Epilepsia do Lobo Temporal / Neurocirurgia Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: Seizure Assunto da revista: NEUROLOGIA Ano de publicação: 2005 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido