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Mesial temporal sclerosis in children
Eliana Maria Domingues Brandão1, Maria Luiza Giraldes de Manreza
1Divisão de Neurologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Rua Vicente Oropallo 612, São Paulo, SP, Brazil. sermaju@uol.com.br
Insights
Mesial temporal sclerosis, a cause of epilepsy, is uncommon in children. This study found febrile seizures may directly link to left-sided mesial temporal sclerosis in pediatric patients.
Area of Science:
- Neurology
- Pediatric Epilepsy
Background:
- Mesial temporal sclerosis is a primary cause of drug-resistant temporal lobe epilepsy.
- It is generally considered infrequent in pediatric populations.
Purpose of the Study:
- To characterize the clinical, electrographic, and radiological features of mesial temporal sclerosis in children.
- To explore potential associations between patient history and disease presentation.
Main Methods:
- Retrospective chart review of 44 pediatric patients diagnosed with mesial temporal sclerosis via MRI.
- Data analysis included clinical history, seizure characteristics, and imaging findings.
Main Results:
- A history of febrile seizures was present in 54% of patients.
- Left-sided lesions were more common in children with schooling difficulties, early-onset seizures (6 months-5 years), and complex febrile seizures.
- Eight out of thirteen surgically treated patients achieved seizure freedom.
Conclusions:
- Febrile seizures may have a direct association with left-sided mesial temporal sclerosis in children.
- Early identification and management of febrile seizures could be important in pediatric epilepsy.
Unlabelled:
Mesial temporal sclerosis is the most frequent cause of drug-resistant temporal lobe epilepsy but has a satisfactory response to surgery, and is considered infrequent in children.
Objective:
To evaluate the clinical, electrographic and radiological spectrum of the disease in children.
Method:
Retrospective study by review of charts of 44 children with a diagnosis of mesial temporal sclerosis on magnetic resonance imaging, attended at the "Hospital das Clínicas" of the University of São Paulo Faculty of Medicine.
Results:
Febrile seizure was identified in the history of 54% of the patients. Injuries at the left side predominated in patients with schooling difficulties (p=0.049), in those with first seizures between six months and five years (p=0.021) and in those with complex febrile seizure (p=0.032). Thirteen patients were submitted to surgery and of these, eight remained without seizures.
Conclusion:
Febrile seizure may be related in a more direct way to the presence of left-side mesial temporal sclerosis.
