Comparison of temporal lobectomies of children and adults with intractable temporal lobe epilepsy.
BACKGROUND
The aim of the study was to assess the difference in clinical characteristics and postsurgical outcomes between children and adults who have undergone temporal lobectomy (TL).


METHODS
We retrospectively reviewed the medical records of 52 patients who had undergone TL between 2006 and 2008. Nineteen patients were classified as children (<or=18 years old), and 33 patients were classified as adults (>18 years old) according to the age when TL had been performed.


RESULTS
Twelve of 19 (63.2%) children and 24 of 33 (72.7%) adults became seizure free. Rapid secondary generalization such as generalized tonic or tonic-clonic seizures showed a tendency to be more prominent in children (four of 19, 21.1%) than in adults (three of 33, 9.1%). Patients in childhood had significantly more multifocal discharges on interictal electroencephalography (EEG) (42.1%) compared to adults (15.2%, p = 0.014). The mean extent of surgical excision was 5.0 cm in children and 4.1 cm in adults (p = 0.001). The incidence of hippocampal sclerosis, the most common pathologic finding in the two groups, was 57.9% (11 of 19) in children and 78.8% (26 of 33) in adults. Malformations of cortical development were significantly more frequent in children (nine of 19, 47.4%) than in adults (seven of 33, 21.2%). Dual pathology was found in 31.6% of children and in 12.1% of adults. The intelligence quotient and memory quotient values in children with temporal lobe resection remained nearly steady during follow-up period without significant decline.


CONCLUSIONS
Patients undergoing TL during childhood compared to during adulthood had distinctively different interictal EEG, resectional extents, and pathologic findings.
Lee
Yun Jin
YJ
Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Brain Research Institute, College of Medicine, Yonsei University, Seoul, Republic of Korea.
Kang
Hoon-Chul
HC
Bae
Sun Joon
SJ
Kim
Heung Dong
HD
Kim
Jeong Tae
JT
Lee
Byung In
BI
Heo
Kyoung
K
Jang
Jin Woo
JW
Kim
Dong Seok
DS
Kim
Tae Seung
TS
Lee
Joon Soo
JS
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D038481:Anterior Temporal Lobectomy / Q000009:adverse effects / Q000379:methods; D001921:Brain / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D002648:Child; D004829:Epilepsy, Generalized / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D004833:Epilepsy, Temporal Lobe / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D004830:Epilepsy, Tonic-Clonic / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012640:Seizures / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult