Abstracts

Temporal lobe epilepsy (TLE) that begins in early life is often a catastrophic disorder with pharmaco-resistant seizures and secondary neurological deterioration. Few data are available regarding epilepsy surgery performed during infancy and early childhood and no prior study has focused on TLE., We analyzed the results of temporal resection, performed for epilepsy as the primary indication, between 1979 and 2003, in children less than age 5 years at time of surgery who had at least 2 years of follow-up., 20 children (14 males) were identified with a mean age at surgery of 26 months and a mean age at seizure onset of 12 months. Clinical presentation was age-dependent. Typical psychomotor seizures (n=4; mean age at surgery 37 months) may be followed by prominent motor changes (n=7; 30 months) that can be isolated (n=3; 23 months). Epileptic spasms were noted in 6 patients and were frequently associated with partial seizures. The interictal EEG was lateralizing in 15 patients and ictal EEG was lateralizing in 18 patients. Brain MRI had good predictive value in 16 patients; ictal SPECT was concordant in 4/8 patients. Invasive EEG was employed in 6 cases. At mean follow-up of 5.5 years, 65% of the children were seizure-free and 15% had [gt] 90% seizure reduction. Morbidity included infection and hydrocephalus in one case and stroke-related hemiparesis in two cases. Cortical dysplasia was identified in 8 children, tumors in 8 including 2 DNET, 2 ganglioglioma, and 4 malignant tumors. Hippocampal sclerosis was present in 4 cases as dual pathology., Surgery for TLE can be performed during early life with similar results as in older children and in adults.,