title: Childhood onset temporal lobe epilepsy: Beyond hippocampal sclerosis.
abstract: OBJECTIVE
  Hippocampal Sclerosis (HS) is widely recognized as a significant underlying cause of drug-resistant temporal lobe epilepsy (TLE) in adults. In contrast, HS is a rare finding in pediatric surgical series, and a higher incidence of HS associated with cortical dysplasia (i.e. FCD type IIIa according to the new ILAE classification) than in adult series has been reported. Data about the electro-clinical characteristics of this subgroup are scarce.
  
  
  METHODS
  We studied 15 children and adolescents with drug-resistant TLE and HS who had anterior temporal lobe resection at our center with regard to electroclinical characteristics, MRI features and histopathology. Children in whom histopathology was consistent with Focal Cortical Dysplasia (FCD) type IIIa (n = 7) were compared with those who had HS only (n = 8).
  
  
  RESULTS
  Clinical characteristics associated with this highly selective subset of patients with FCD type IIIa were: the presence of febrile seizures during infancy, a shorter duration of active epilepsy and a lower age at epilepsy surgery. In addition, there were non-significant trends towards more extended abnormalities on both EEG and neuroimaging. We were, however, not able to find group differences with respect to neuropathologic subtyping of the HS.
  
  
  CONCLUSIONS
  We present the first detailed description and comprehensive data analysis of children with FCD type IIIa. According to our results, this patient group seems to show a distinct clinical phenotype.
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: angelika.muehlebner@meduniwien.ac.at.
authors.forename: Angelika
authors.initials: A
authors.lastname: Mühlebner
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: markus.breu@meduniwien.ac.at.
authors.forename: Markus
authors.initials: M
authors.lastname: Breu
authors.affiliation: Department of Radiology, Medical University Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: gregor.kasprian@meduniwien.ac.at.
authors.forename: Gregor
authors.initials: G
authors.lastname: Kasprian
authors.affiliation: Department of Radiology, Medical University Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: maria.schmook@meduniwien.ac.at.
authors.forename: Maria T
authors.initials: MT
authors.lastname: Schmook
authors.affiliation: Department of Neurosurgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria; Institute of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: herald.stefanits@meduniwien.ac.at.
authors.forename: Harald
authors.initials: H
authors.lastname: Stefanits
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria; Institute of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: theresa.scholl@meduniwien.ac.at.
authors.forename: Theresa
authors.initials: T
authors.lastname: Scholl
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: sharon.samueli@meduniwien.ac.at.
authors.forename: Sharon
authors.initials: S
authors.lastname: Samueli
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: gudrun.groeppel@meduniwien.ac.at.
authors.forename: Gudrun
authors.initials: G
authors.lastname: Gröppel
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: anastasia.dressler@meduniwien.ac.at.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Dressler
authors.affiliation: Department of Radiology, Medical University Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: daniela.prayer@meduniwien.ac.at.
authors.forename: Daniela
authors.initials: D
authors.lastname: Prayer
authors.affiliation: Department of Neurosurgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: thomas.czech@meduniwien.ac.at.
authors.forename: Thomas
authors.initials: T
authors.lastname: Czech
authors.affiliation: Institute of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: johann.hainfellner@meduniwien.ac.at.
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Hainfellner
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: martha.feucht@meduniwien.ac.at.
authors.forename: Martha
authors.initials: M
authors.lastname: Feucht
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D000069279:Drug Resistant Epilepsy / Q000209:etiology* / Q000503:physiopathology; D004833:Epilepsy, Temporal Lobe / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D054220:Malformations of Cortical Development / Q000150:complications* / Q000473:pathology; D010641:Phenotype; D012598:Sclerosis; D003294:Seizures, Febrile / Q000150:complications
keywords: Epilepsy surgery; Neuropathology; Pediatrics; Temporal lobe epilepsy