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[Epilepsy due to mesiotemporal sclerosis in children: 10 cases]
Background:
Mesio-temporal sclerosis is a frequent and probably underestimated cause of resistant temporal epilepsy in childhood.
Patients And Methods:
Ten patients originating from West and North-East France are reported in this retrospective study. They were referred for partial temporal epilepsy which had begun between the ages of 3.5 and 15 years. Mesio-temporal sclerosis was diagnosed on MRI (ten cases) and on neuropathological examination (three cases).
Results:
Complex partial seizures were noted in all patients, with most frequently fear, abnormal epigastric perception and oro-alimentary automatisms. Social and educational issues were altered due to frequent seizures and amnesic disturbances. An initial event, always a complex febrile seizure, was found in six patients. MRI study showed in all patients unilateral hippocampal atrophy and/or an increase in hippocampal T2 signal intensity on coronal sections. Ictal EEG showed homolateral temporal seizures six times. Hippocampo-amygdalectomy was performed in three patients with a good outcome.
Conclusion:
Epilepsy associated with mesio-temporal sclerosis belongs to intractable epilepsy in childhood. Early recognition of its symptoms would allow early pre-operative assessment in order to minimize developmental defects due to continuing epilepsy, and adverse cognitive effects of anti-epileptics.