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Temporal lobectomy for intractable complex partial seizures in pediatric patients
P Visudhiphan1, S Bunyaratavej, A Visudtibhan
1Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Summary
Anterior temporal lobectomy effectively treated complex partial seizures in 70% of pediatric patients, improving behavior. This epilepsy surgery offers hope for children unresponsive to medication.
Area of Science:
- Neurosurgery
- Pediatric Neurology
- Epileptology
Background:
- Complex partial seizures in children often resist medical management.
- Refractory epilepsy necessitates surgical intervention for improved quality of life.
- Anterior temporal lobectomy is a potential treatment for drug-resistant epilepsy.
Purpose of the Study:
- To evaluate the efficacy of anterior temporal lobectomy in pediatric patients with complex partial seizures.
- To assess seizure control and behavioral outcomes post-surgery.
- To correlate surgical findings with patient outcomes.
Main Methods:
- Retrospective analysis of 14 children (7 boys, 7 girls) undergoing anterior temporal lobectomy.
- Presurgical evaluation included video-EEG, MRI, and SPECT.
- Surgical outcomes assessed based on seizure freedom and behavioral improvement over 0.5-5 years.
Main Results:
- 70% of patients achieved seizure freedom, with higher success in unilateral lesions (9/10).
- Significant seizure reduction observed in remaining patients.
- Marked behavioral improvement noted in 70% of cases.
- Histopathology revealed mesial temporal sclerosis, gliosis, tumors, and cavernoma.
Conclusions:
- Anterior temporal lobectomy is an effective treatment for pediatric complex partial seizures refractory to medical therapy.
- The procedure offers significant seizure reduction and behavioral benefits.
- Unilateral temporal lobe lesions correlate with better seizure control post-surgery.