Surgery for medically intractable temporal lobe epilepsy during early life

Bruno Maton, Prasanna Jayakar, Trevor Resnick, Glenn Morrison, John Ragheb, Michael Duchowny

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Purpose: Temporal lobe epilepsy (TLE) in early life is often a catastrophic disorder with pharmacoresistant seizures and secondary neurological deterioration. There is little data available regarding epilepsy surgery performed in infants and young children and no prior study has focused on TLE. Methods: We analyzed the results of temporal resection for epilepsy as the primary indication in children less than age 5 years who had at least 2 years of follow-up. Results: 20 children (14 males) were identified with a mean age at surgery of 26 months and a mean age at seizure onset of 12 months. Clinical presentation was diverse. Typical psychomotor seizures (n = 4; mean age at surgery 37 months) were followed by prominent motor changes (n = 7; 30 months) and were occasionally isolated (n = 3; 23 months). Epileptic spasms were noted in six patients and were frequently associated with lateralizing features. The interictal EEG was lateralizing in 15 patients and the ictal EEG was lateralizing in 18 patients. Brain MRI provided localizing value in 16 patients, ictal SPECT was concordant in 4/8 cases. Invasive EEG was employed in six cases. At mean follow-up of 5.5 years, 65% of the children were seizure-free and 15% had >90% seizure reduction. Morbidity included infection and hydrocephalus in one case and stroke-related hemiparesis in two cases. Cortical dysplasia was identified in eight children, tumors in eight including two DNET, two ganglioglioma, and four malignant tumors. Hippocampal sclerosis was present in four cases, always as dual pathology. Conclusion: TLE presents in early life with varied and severe manifestations. Excisional procedures in this age group are associated with favorable seizure reduction similar to older children and in adults.

Original languageEnglish
Pages (from-to)80-87
Number of pages8
JournalEpilepsia
Volume49
Issue number1
DOIs
StatePublished - Jan 1 2008

Fingerprint

Temporal Lobe Epilepsy
Seizures
Electroencephalography
Stroke
Epilepsy
Ganglioglioma
Malformations of Cortical Development
Spasm
Sclerosis
Paresis
Hydrocephalus
Single-Photon Emission-Computed Tomography
Age of Onset
Drug Resistant Epilepsy
Neoplasms
Age Groups
Pathology
Morbidity
Brain
Infection

Keywords

  • Cortical resection
  • Epilepsy surgery
  • Temporal lobe epilepsy
  • Young children

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Maton, B., Jayakar, P., Resnick, T., Morrison, G., Ragheb, J., & Duchowny, M. (2008). Surgery for medically intractable temporal lobe epilepsy during early life. Epilepsia, 49(1), 80-87. https://doi.org/10.1111/j.1528-1167.2007.01315.x

Surgery for medically intractable temporal lobe epilepsy during early life. / Maton, Bruno; Jayakar, Prasanna; Resnick, Trevor; Morrison, Glenn; Ragheb, John; Duchowny, Michael.

In: Epilepsia, Vol. 49, No. 1, 01.01.2008, p. 80-87.

Research output: Contribution to journalArticle

Maton, B, Jayakar, P, Resnick, T, Morrison, G, Ragheb, J & Duchowny, M 2008, 'Surgery for medically intractable temporal lobe epilepsy during early life', Epilepsia, vol. 49, no. 1, pp. 80-87. https://doi.org/10.1111/j.1528-1167.2007.01315.x
Maton B, Jayakar P, Resnick T, Morrison G, Ragheb J, Duchowny M. Surgery for medically intractable temporal lobe epilepsy during early life. Epilepsia. 2008 Jan 1;49(1):80-87. https://doi.org/10.1111/j.1528-1167.2007.01315.x
Maton, Bruno ; Jayakar, Prasanna ; Resnick, Trevor ; Morrison, Glenn ; Ragheb, John ; Duchowny, Michael. / Surgery for medically intractable temporal lobe epilepsy during early life. In: Epilepsia. 2008 ; Vol. 49, No. 1. pp. 80-87.
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