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Updated: Jul 14, 2026
Network Analysis of the Default Mode Network Using Functional Connectivity MRI in Temporal Lobe Epilepsy
Published on: August 5, 2014
Relative frequency, clinical, neuroimaging, and postsurgical features of pediatric temporal lobe epilepsy
L V Sales1, T R Velasco, S Funayama
1Departamento de Neurologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Avenida Bandeirantes 3900, 14049-900 Ribeirão Preto, SP, Brazil.
Insights
Pediatric temporal lobe epilepsy (TLE) is rare but more common in children with difficult-to-treat seizures. Surgical intervention improved seizure control in TLE patients with specific brain lesions.
Area of Science:
- Neurology
- Pediatric Epilepsy
- Neuroimaging
Background:
- Temporal lobe epilepsy (TLE) is a common form of focal epilepsy, particularly in children.
- Understanding the characteristics and outcomes of pediatric TLE is crucial for effective management.
- Brazilian epilepsy centers provide valuable insights into TLE prevalence and treatment responses.
Purpose of the Study:
- To determine the relative frequency of pediatric TLE in a Brazilian epilepsy center.
- To analyze clinical features, neuroimaging findings, and treatment outcomes in children with TLE.
- To compare outcomes based on MRI findings and intervention type (pharmacological vs. surgical).
Main Methods:
- Retrospective review of medical records of children under 12 with suspected TLE.
- Classification of patients into three groups based on MRI: hippocampal atrophy, normal MRI, or other temporal lesions.
- Evaluation of seizure frequency before and after pharmacological or surgical treatment.
Main Results:
- The overall relative frequency of TLE in pediatric epilepsy was 1.79%, but increased to 19.11% in cases requiring video-EEG monitoring and 31.25% in epilepsy surgery candidates.
- Seizure frequency significantly decreased in patients with hippocampal atrophy (G1) and other specific temporal lesions (G3) post-treatment, particularly after surgery.
- Patients with normal MRI (G2) showed no significant improvement in seizure control with the interventions used.
Conclusions:
- Pediatric TLE is infrequent overall but significantly more prevalent in children with intractable epilepsy.
- Surgical intervention offers good outcomes for pediatric TLE patients with identifiable lesions on MRI.
- Further research is needed to optimize management strategies for pediatric TLE, especially in cases with normal MRI findings.
Abstract:
We describe the relative frequency, clinical features, neuroimaging and pathological results, and outcome after pharmacological or surgical intervention for a series of pediatric patients with temporal lobe epilepsy (TLE) from an epilepsy center in Brazil. The medical records of children younger than 12 years with features strongly suggestive of TLE were reviewed from January 1999 to June 1999. Selected children were evaluated regarding clinical, EEG, and magnetic resonance imaging (MRI) investigation and divided into three groups according to MRI: group 1 (G1, N = 9), patients with hippocampal atrophy; group 2 (G2, N = 10), patients with normal MRI, and group 3 (G3, N = 12), patients with other specific temporal lesions. A review of 1732 records of children with epilepsy revealed 31 cases with TLE (relative frequency of 1.79%). However, when the investigation was narrowed to cases with intractable seizures that needed video-EEG monitoring (N = 68) or epilepsy surgery (N = 32), the relative frequency of TLE increased to 19.11 (13/68) and 31.25% (10/32), respectively. At the beginning of the study, 25 of 31 patients had a high seizure frequency (80.6%), which declined to 11 of 31 (35.5%) at the conclusion of the study, as a consequence of pharmacological and/or surgical therapy. This improvement in seizure control was significant in G1 (P < 0.05) and G3 (P < 0.01) mainly due to good postsurgical outcome, and was not significant in G2 (P > 0.1, McNemar's test). These results indicate that the relative frequency of TLE in children was low, but increased considerably among cases with pharmacoresistant seizures. Patients with specific lesions were likely to undergo surgery, with good postoperative outcomes.
