Pathology and neuroimaging in pediatric temporal lobectomy for intractable epilepsy

被引:27
|
作者
Sinclair, DB [1 ]
Wheatley, M [1 ]
Aronyk, K [1 ]
Hao, C [1 ]
Snyder, T [1 ]
Colmers, W [1 ]
McKean, JDS [1 ]
机构
[1] Univ Alberta Hosp, Comprehens Epilepsy Program, Edmonton, AB T6G 2B7, Canada
关键词
pediatric epilepsy; pathology; neuroimaging; epilepsy surgery;
D O I
10.1159/000050429
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objectives: Firstly, to study the pathology at surgery in children undergoing temporal lobectomy for intractable partial epilepsy. Secondly, to compare neuroimaging techniques (CT, MRI) in the preoperative detection of pathology. Lastly, to examine the surgical outcome in children. Methods: Forty-two pediatric patients undergoing temporal lobectomy for intractable epilepsy at the Comprehensive Epilepsy Program at the University of Alberta Hospital between the years 1988-1998 were studied. Patients had extensive preoperative investigations including CT and MRI. The pathology at surgery was reviewed and compared to preoperative neuroimaging. Charts were reviewed to determine surgical outcome. Results: Brain tumors were the most common pathology, found in 13/42 patients. Mesial temporal sclerosis (MTS) was found in 8 patients and dual pathology in an additional 5. Focal cortical dysplasia (FCD) was seen in 4 patients, 1 patient had a porencephalic cyst and 4 patients had tubers of tuberous sclerosis. Seven patients had no specific pathology detected. MRI was clearly more sensitive than CT in the detection of pathology. MRI was abnormal in 27/42 cases (64%), while CT scan was found to be abnormal in only 12/39 (31%). Surgical outcome was excellent, with 34/42 patients (80%) having an Engel class I outcome. One patient had significant improvement with an Engel class II outcome, 3 (7%) had little improvement (Engel class III) and 4 (10%) were unchanged (Engel class IV). Three patients (7%) had surgical complications. Conclusions: A wide variety of developmental pathology is seen following temporal lobectomy for intractable epilepsy of childhood. Brain tumors, FCD and MTS are common. MRI is superior to CT in the detection of pathology, which may be subtle in children. Surgical outcome is excellent, with most children being seizure free and few complications being seen. Copyright (C) 2001 S. Karger AG, Basel.
引用
收藏
页码:239 / 246
页数:8
相关论文
共 50 条
  • [1] Cognition and behavior after temporal lobectomy in pediatric patients with intractable epilepsy
    Williams, J
    Griebel, ML
    Sharp, GB
    Boop, FA
    PEDIATRIC NEUROLOGY, 1998, 19 (03) : 189 - 194
  • [2] Tailored Temporal Lobectomy for Medically Intractable Epilepsy: Evaluation of Pathology and Predictors of Outcome
    Falowski, Steven M.
    Wallace, David
    Kanner, Andres
    Smith, Michael
    Rossi, Michael
    Balabanov, Antoaneta
    Ouyang, Bichun
    Byrne, Richard W.
    NEUROSURGERY, 2012, 71 (03) : 703 - 709
  • [3] PATHOLOGY OF TEMPORAL LOBECTOMY FOR EPILEPSY
    MUNOZ, DG
    BRAIN PATHOLOGY, 1994, 4 (04) : 305 - 305
  • [4] Pediatric temporal lobectomy for epilepsy
    Sinclair, DB
    Aronyk, K
    Snyder, T
    McKean, J
    Wheatley, M
    Bhargava, R
    Hoskinson, M
    Hao, C
    Colmers, W
    PEDIATRIC NEUROSURGERY, 2003, 38 (04) : 195 - 205
  • [5] Tailored Temporal Lobectomy for Medically Intractable Epilepsy: Evaluation of Pathology and Predictors of Outcome COMMENTS
    Shetter, Andrew G.
    Cossu, Massimo
    NEUROSURGERY, 2012, 71 (03) : 709 - 709
  • [6] Depression following temporal lobectomy in intractable temporal lobe epilepsy
    Kovacevic, M.
    Parojcic, A.
    Vojvodic, N.
    Ristic, A.
    Bascarevic, V.
    Dukic, T.
    Pejovic, A.
    Sokic, D.
    EUROPEAN JOURNAL OF NEUROLOGY, 2019, 26 : 617 - 617
  • [7] Coping after temporal lobectomy for intractable epilepsy seizures
    Moore, SM
    Murphy, M
    PSYCHOSOMATIC MEDICINE, 2002, 64 (01): : 168 - 168
  • [8] Coping after temporal lobectomy for intractable epilepsy seizures
    Moore, S.
    Murphy, M.
    AUSTRALIAN JOURNAL OF PSYCHOLOGY, 2001, 53 : 167 - 167
  • [9] Neuroimaging in pediatric temporal lobe epilepsy: Does neuroimaging accurately predict pathology and surgical outcome?
    Kassiri, Janani
    Elliott, Cameron
    Liu, Natarie
    Mailo, Janette
    Rajapakse, Thilinie
    Schmitt, Laura
    Wheatley, Matthew
    Sinclair, D. Barry
    EPILEPSY RESEARCH, 2021, 175
  • [10] Pediatric intractable epilepsy: A functional neuroimaging diagnostic challenge
    Yassin, SWT
    EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2004, 31 : S364 - S364