This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Sotero de Menezes, M. A. Articles by Riviello, J. J. Search for Related Content PubMed PubMed Citation Articles by Sotero de Menezes, M. A. Articles by Riviello, J. J., JR Social Bookmarking                         What's this?

Temporal Lobectomy in Early Childhood: The Need for Long-Term Follow-Up

Department of Neurology Children's Hospital and Regional Medical Center, University of Washington, Seattle, WA, msoter{at}chmc.org

Mary Connolly, MD

Department of Child Neurology British Columbia Children's Hospital University of British Columbia, Vancouver, BC

Addison Bolanos, MD

Division of Epilepsy and Clinical Neurophysiology, Department of Neurology Children's Hospital and Harvard Medical School, Boston, MA

Joseph Madsen, MD

Department of Neurosurgery Children's Hospital and Harvard Medical School, Boston, MA

Peter McL. Black, MD, PhD

Department of Neurosurgery Children's Hospital and Harvard Medical School, Boston, MA

James J. Riviello, JR, MD

Division of Epilepsy and Clinical Neurophysiology, Department of Neurology Children's Hospital and Harvard Medical School, Boston, MA

We retrospectively identified 15 children ages 12 years and under with anticonvulsant resistant epilepsy who underwent a temporal lobectomy at Children's Hospital, Boston, between 1978 and 1993. Our aim was to study the long-term seizure outcome. Data pertaining to preoperative evaluation, electroencephalography (EEG), neuroimaging, surgery, seizure outcome, and postoperative complications were reviewed. Only patients followed for more than 12 months were included. The average duration of follow-up was 57 months. At the last visit, 47% (7 of 15) of the children were seizure free or only had auras; another 33% (5 of 15) had > 90% reduction in seizure frequency. Three patients had < 90% seizure reduction. Four cases were initially seizure free but had subsequent recurrence between 11 and 28 months after the epilepsy surgery. Factors associated with a good outcome include exclusively focal EEG discharges or an imaging suggestive of a low-grade tumor; factors associated with a poor outcome include generalized EEG discharges and a normal magnetic resonance image. Temporal lobectomy is useful in the treatment of early childhood drug-resistant partial epilepsy, but long-term follow-up is necessary as late seizure recurrence may occur up to 28 months after surgery. (J Child Neurol 2001;16:585-590).

Journal of Child Neurology, Vol. 16, No. 8, 585-590 (2001)
DOI: 10.1177/088307380101600809


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?