Abstracts

RATIONALE: To evaluate seizure outcome in children undergoing surgery for intractable temporal lobe epilepsy.
METHODS: Eight children who underwent temporal resections for intractable partial onset epilepsy between 1997 and 2001 at University of Michigan were studied.
Clinical features including: age of onset; duration of epilepsy; seizure semiology; inter-ictal/ictal EEG; MRI findings; pathologic substrate and seizure outcome were identified.
RESULTS: Seizures were characterized primarily by loss of awareness and automatisms. A single patient also had nocturnal myoclonic jerks. The average age of seizure onset was 8 years (range: 2 and 17 years). . MRI showed hippocampal sclerosis(3), hippocampal sclerosis and focal cortical dysplasia (1) and an enhancing temporal lobe lesion(4). Interictal EEG identified unilateral temporal spikes (6), bilaterally independent spikes (2). One patient with unilateral temporal spikes also had myoclonic jerks and generalized spike and wave discharges. Pathology revealed hippocampal sclerosis(3), cortical dysplasia (1) patient and low grade tumors with or without associated hippocampal sclerosis (4). Two of the three patientswith hippocampal sclerosis identified by MRI and histo- pathology, had class III A outcome, and the third had a one class I B outcome(ENGEL classification). The remaining 5 patients are seizure free at 1 or 2 years of follow up.
CONCLUSIONS: Temporal lobe epilepsy surgery in children offers an exceelent chance of seizurefreedom which seems to be best correlated with complete resection of the abnormality identified by imaging studies and the non-invasive EEG evaluation.
OBJECTIVE: At the end of this activity the participants should be able to discuss the relationship of seizure outcome after surgery in children with intractable temporal lobe epilesy, based on the underlying etiology.