title: Temporal lobe epilepsy surgery in children and adolescents: clinical characteristics and post-surgical outcome.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Department of Neurology, Hospital das Clinicas, Av Bandeirantes, 3900 Monte Alegre, Brazil. vctbusta@rnp.fmrp.usp.br
authors.forename: Vera Cristina
authors.initials: VC
authors.lastname: Terra-Bustamante
authors.forename: Luciana M
authors.initials: LM
authors.lastname: Inuzuca
authors.forename: Regina M F
authors.initials: RM
authors.lastname: Fernandes
authors.forename: Sandra
authors.initials: S
authors.lastname: Funayama
authors.forename: Sara
authors.initials: S
authors.lastname: Escorsi-Rosset
authors.forename: Lauro
authors.initials: L
authors.lastname: Wichert-Ana
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Santos
authors.forename: David
authors.initials: D
authors.lastname: Araujo
authors.forename: Helio R
authors.initials: HR
authors.lastname: Machado
authors.forename: Americo C
authors.initials: AC
authors.lastname: Sakamoto
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D009493:Neurosurgery / Q000379:methods*; D011184:Postoperative Period; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome