Zhao Rui,Zhou Yuanfeng,Yang Haowei,et al.Clinical characteristics and surgical treatment of temporal lobe epilepsy in children.[J].Journal of Clinical Pediatric Surgery,,17():269-273.
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Clinical characteristics and surgical treatment of temporal lobe epilepsy in children.

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: 第17卷 Number: 2018 04 Page: 269-273 Column: 论著 Date of publication: 2018-04-28
Author(s):
Zhao Rui1; Zhou Yuanfeng2; Yang Haowei3; Shi Wei1; Zhou Shuizhen2; Wang Yi2; Li Hao1
1.Department of Neurosurgery,
Keywords:
Epilepsy; Temporal Lobe;  Surgical Procedures; Operative;  focal cortical dysplasia;  Neoplasms;  Child
Document code:
A
Abstract:
ObjectiveTo explore the clinical characteristics and surgical treatment of intractable temporal lobe epilepsy in children.MethodsA retrospective review was performed for consecutive patients undergoing resection for temporal lobe epilepsy between June 2012 and September 2016.Such clinical characteristics as age,laterality,pathological findings,surgical approaches and seizure outcomes were analyzed.ResultsTwentyfive patients (14 boys,11 girls) with a mean age (±standard deviation) of 6.55±2.98 years (range:2-12 years) were included.The involved side was left (n=11) and right (n=14).Among 24 patients with partial seizures,1 case of generalized seizures was LennoxGastaut syndrome on scalp EEG.Resections included anterior temporal lobe and hippocampus amygdala (n=6),temporal neocortex (n=4),lesion (n=12) and surgery after stereotactic implantation of depth electrode (n=3).The major pathological findings included lowgrade glioma (n=8),focal cortical dysplasia (n=5),cavernous malformations (n=2),lowgrade glioma with cortical dysplasia (FCDⅢb) (n=8) and hippocampal sclerosis with cortical dysplasia (FCDⅢa) (n=2).There was no occurrence of such postoperative complications as bleeding,infection or hydrocephalus.No language or memory impairment was observed after operation.Twentyone patients remained seizurefree (21/25),seizure frequency decreased>75％(n=3,3/12) and <75％ (n=1,1/12).Different surgical approaches had no significant effect on postoperative curative efficacy (P>0.05).Better seizure control outcomes could be obtained under the guidance of electrocorticography (EcoG) monitoring (P=0.034).ConclusionTemporal lobe epilepsy in childhood is different from its adult counterpart.The most common abnormalities are lowgrade tumors and focal cortical dysplasia,but not hippocampus sclerosis.Intraoperative EcoG is a useful adjunct for ensuring a complete removal of epileptogenic zone and achieving optimal seizure freedom.
Last Update: 2018-04-25