Drug-resistant temporal lobe epilepsy: Seizure outcome in children versus adults
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View abstract on PubMed
Summary
This summary is machine-generated.Children with temporal lobe epilepsy (TLE) experience better surgical outcomes than adults, highlighting the importance of early intervention. Catching them young can significantly improve seizure freedom and long-term results.
Area Of Science
- Neurology
- Epileptology
- Pediatric Neurology
Background
- Temporal lobe epilepsy (TLE) is the most common focal epilepsy, with many drug-resistant cases eligible for surgery.
- While pediatric TLE surgery outcomes are often favorable, direct comparisons with adult outcomes using the same surgical procedures are limited.
Purpose Of The Study
- To compare long-term seizure outcomes between pediatric and adult patients undergoing TLE surgery.
- To identify prognostic factors influencing surgical success in both age groups.
Main Methods
- A cohort of 684 patients (127 children, 557 adults) underwent standard anterior temporal lobectomy.
- Presurgical evaluation included video EEG and neuroimaging; seizure freedom was the primary outcome.
- Logistic regression and Kaplan-Meier curves were used to analyze predictors and long-term seizure-free survival.
Main Results
- Children had shorter epilepsy duration (8.38 vs. 19.2 years) and better seizure outcomes (57.4% vs. 45.6%) compared to adults.
- Median seizure-free survival was longer in children (120 months) than adults (72 months).
- Predictors of poor outcome in adults included specific auras and EEG findings; febrile seizures predicted favorable outcomes in both groups. Neoplasia was protective in children, while psychiatric comorbidities predicted recurrence.
Conclusions
- Pediatric patients demonstrate superior long-term seizure control after TLE surgery compared to adults.
- Earlier surgical intervention in children, evidenced by shorter epilepsy duration, contributes to better outcomes.
- The findings underscore the principle of "time is brain" in epilepsy, advocating for early surgical referral to prevent network expansion and improve seizure control.
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