Abstracts

Rationale: Obesity is a significant public health problem. Children with epilepsy may be at increased risk for overweight and obesity due to antiepileptic medications, physical inactivity and neuroendocrine factors. We studied the rate of obesity in children with temporal lobe epilepsy and analysed weight changes after epilepsy surgery. Methods: We identified 108 children aged 2 years to 18 years with temporal lobe epilepsy, who underwent temporal lobe resection between 1998 to 2009. A retrospective data analyses included weight, height and BMI index prior and 2 years post surgery, age of seizure onset, age at surgery, seizure frequencies, mesial or lateral temporal pathology. Results: Mean patient age at temporal lobectomy was 12.1 years ( range 2 to 18 years), 85% had mesial temporal limbic structures removed. Pathology included hippocampal sclerosis in 63%, low grade tumors in 26% (ganglioglioma, DNET), cortical dysplasia in 13%, remote infarct, encephalitis, cavernous angioma in 6%. BMI Z scores and BMI percentiles were calculated with SAS Program using the CDC growth charts. 27 children (25%) were obese (BMI > 95% for age) and 22 children (25%) were overweight (BMI % between 85% and 95% for age). The group BMI did not change significantly 2 years after surgery. Conclusions: Over half the children with temporal lobe epilepsy were overweight or obese persisting after temporal lobectomy. This rate is significantly higher than national survey data (31.6% of children in Ohio are overweight or obese, p<0.03, CI 95%, 0.366 to 0.5522). It is also higher than was recently reported in children with new onset epilepsy. Children with temporal lobe epilepsy maybe at particular risk for obesity. These results need to be replicated with larger cohorts. Early diagnosis and intervention to reduce long term morbidity associated with obesity will be important.