Mesial temporal lobe epilepsy with hippocampal sclerosis: Study of 42 children

Abstract Purpose We present the electroclinical features, treatment, and evolution of patients with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). Material and methods We analyzed the charts of forty-two patients who met the diagnostic criteria of MTLE-HS. The mean follow-up aft...

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Bibliographic Details
Published in:Seizure (London, England) England), 2011-03, Vol.20 (2), p.131-137
Main Authors: Cersósimo, Ricardo, Flesler, Santiago, Bartuluchi, Marcelo, Soprano, Ana María, Pomata, Hugo, Caraballo, Roberto
Format: Article
Language:English
Subjects:
Adolescence
Adolescent
Age of Onset
Brain Diseases - complications
Brain Diseases - pathology
Brain Diseases - physiopathology
Child
Child, Preschool
Childhood
Electroencephalography
Epilepsy
Epilepsy, Temporal Lobe - complications
Epilepsy, Temporal Lobe - physiopathology
Epilepsy, Temporal Lobe - surgery
Female
Hippocampus - pathology
Hippocampus - physiopathology
Hippocampus - surgery
Humans
Infancy
Infant
Male
Mesial temporal lobe
Neurology
Neurosurgical Procedures
Sclerosis - pathology
Surgery
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Summary:Abstract Purpose We present the electroclinical features, treatment, and evolution of patients with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). Material and methods We analyzed the charts of forty-two patients who met the diagnostic criteria of MTLE-HS. The mean follow-up after seizure onset was 10.5 years. Results According to age, we defined three groups. The first group included nine patients that started with seizures before 2 years of age. Motor seizures were the hallmark clinical manifestation. All patients of this group also presented with motor arrest and oro-alimentary automatisms. In three of them, the interictal EEG recordings showed bilateral paroxysms predominantly in anterior regions, in addition to focal abnormalities, and two had an apparently generalized ictal pattern. The second group included 17 patients that started with seizures between 2 and 10 years of age. In this group the automatisms were also oroalimentary, but more complex and the patients had less motor manifestations. The interictal EEG recordings showed temporal abnormalities. The ictal EEG recordings showed lateralized abnormalities with a maximum in the temporal electrodes. The third group included 16 patients that started with seizures between 10 and 16 years of age. The most common clinical manifestation was abdominal aura followed by oroalimentary, gestural, and verbal automatisms. The interictal and ictal EEG recordings showed well-localized abnormalities in temporal lobes. Thirty-eight patients underwent surgical treatment. Thirty-five patients are seizure free. Conclusion MTLE-HS represents a well-defined and distinct symptomatic epileptic syndrome. Surgical treatment was successful in most patients.
ISSN:1059-1311
1532-2688
DOI:10.1016/j.seizure.2010.11.002