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Updated: Oct 13, 2026
Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study
Published on: August 15, 2025
Surgical treatment of temporal tumors associated with epilepsy in children
A Iannelli1, F Guzzetta, D Battaglia
1Institute of Neurosurgery, Section of Pediatric Neurosurgery, Catholic University, Rome, Italy. Iannel@tiscalinet.it
Insights
Pediatric temporal lobe tumors frequently cause seizures, often as the first symptom. Radical tumor resection is the most crucial factor for achieving seizure control in children.
Area of Science:
- Pediatric Neurology
- Neuro-oncology
- Epileptology
Background:
- Seizures are a common presenting symptom in pediatric supratentorial tumors.
- Temporal lobe tumors are particularly associated with a high incidence of epilepsy in children.
Purpose of the Study:
- To investigate the characteristics of pediatric temporal epileptogenic tumors.
- To evaluate the relationship between tumor resection extent and seizure control.
Main Methods:
- Retrospective analysis of 37 pediatric patients with temporal lobe tumors.
- Clinical and histological evaluation of tumors and seizure types.
- Assessment of seizure outcomes based on Engel's classification post-surgery.
Main Results:
- Epilepsy was the initial and sole symptom in 62% of patients.
- Partial complex seizures were most frequent (56%).
- Radical tumor resection was the most significant predictor of seizure control.
Conclusions:
- Temporal lobe tumors in children frequently manifest as epilepsy.
- Complete surgical resection of the tumor is essential for effective long-term seizure management.
Abstract:
Seizures are a frequent sign of cerebral supratentorial tumors in children, especially when the location of the neoplasm is the temporal lobe. We report a series of 37 pediatric patients with temporal epileptogenic tumors. They represent 80.4% of children affected by temporal neoplasms, confirming the high incidence of seizures when neoplasms are located in this cerebral area. There was a slight male predominance. Epilepsy was the first symptom in all the patients of our series, as well as the only clinical manifestation present until surgery in 62% of patients. In the remaining children, hemiparesis, intracranial hypertension, psychosocial or neuropsychological disabilities, and delayed milestones arose before diagnosis and surgical treatment. The most frequent type of seizures was the partial complex (56%), but simple partial or generalized fits, as well as more than one type of seizures, were observed. The medial temporal structures were those more commonly involved, although seizures were observed also in cases where they were spared by tumors located exclusively in the temporal neocortex. On histology, most of the tumors showed a benign phenotype. Tumor resection was complete in 60% of cases; the excision of the tumor was incomplete in subjects whose lesion involved surgically inaccessible cerebral regions, as language areas, insular structures, and basal nuclei. As for epilepsy, 26 among the 32 long-term survivors can be classified in class I of Engel's classification; 4 of them did not receive any antiepileptic treatment. Four patients showed a significant reduction in the frequency of their fits. In 2 subjects, only the frequency of seizures was minimally reduced after tumor excision; in both, a partial removal of their tumor was performed. The relationship among the results on epilepsy and the extent of surgery removal of the tumor, brain tissue removal if any, frequency of seizures in the preoperative period and the time interval between the first epileptic manifestation and surgery show that the most significant prognostic element predictive of a good control of seizures is radical resection of the tumor.
