Temporal Lobe Surgery in Pediatric Patients: From Temporal Lobe Epilepsy to Temporal Plus Epilepsy
Purpose Temporal lobe resection can be categorized as either temporal lobe epilepsy (TLE), which involves cortical resection confined to the temporal lobe, or temporal plus epilepsy (TPE), which entails temporal resection along with involvement of additional extratemporal regions. We compared these...
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Korean Child Neurology Society
2024-10-01
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| Series: | Annals of Child Neurology |
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| Online Access: | http://annchildneurol.org/upload/pdf/acn-2024-00633.pdf |
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| author | Jun Chul Byun Hye Eun Kwon Hoon-Chul Kang Joon Soo Lee Heung Dong Kim |
| author_facet | Jun Chul Byun Hye Eun Kwon Hoon-Chul Kang Joon Soo Lee Heung Dong Kim |
| author_sort | Jun Chul Byun |
| collection | DOAJ |
| description | Purpose Temporal lobe resection can be categorized as either temporal lobe epilepsy (TLE), which involves cortical resection confined to the temporal lobe, or temporal plus epilepsy (TPE), which entails temporal resection along with involvement of additional extratemporal regions. We compared these forms within a pediatric population. Methods We identified 136 patients who underwent temporal resection over a 17-year period and investigated the differences in the clinical profiles and seizure outcomes between TLE and TPE. Results Of the total sample, 110 patients (80.9%) presented with TLE and 26 (19.1%) with TPE. Significant differences were observed between the groups in age at seizure onset (TLE: 6.3 years, TPE: 0.9 years; P=0.001), age at epilepsy surgery (TLE: 14.2 years, TPE: 9.2 years; P=0.002), the proportion of patients with a history of infantile epileptic spasm syndrome (IESS) (TLE: 6 [5.5%], TPE: 8 [30.3%]; P<0.001), electroclinical presentation with IESS or Lennox-Gastaut syndrome (LGS) (TLE: 11 [10.0%], TPE: 13 [50.0%]; P<0.001), the presence of focal temporal hypometabolism on positron emission tomography (TLE: 74 [68.5%], TPE: 11 [44.0%], P=0.021), and the use of intracranial electroencephalogram monitoring (TLE: 58 [52.7%], TPE: 21 [80.8%]; P=0.009). Furthermore, multivariate analysis identified the epileptic presentation of IESS or LGS as a significant predictor of TPE (P=0.049). The rates of seizure outcomes of International League Against Epilepsy class 1–3 at 1 year of follow-up were 83.8% for the entire cohort, 89.1% for TLE, and 61.5% for TPE (P=0.002). Conclusion TPE appears to represent a substantial subset of pediatric temporal resections. The variation in seizure outcomes between groups underscores the importance of predicting TPE in advance, with implications for effective treatment planning. |
| format | Article |
| id | doaj-art-9689ec5c52a94c6f91066a84f905f4df |
| institution | Kabale University |
| issn | 2635-909X 2635-9103 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Korean Child Neurology Society |
| record_format | Article |
| series | Annals of Child Neurology |
| spelling | doaj-art-9689ec5c52a94c6f91066a84f905f4df2024-11-18T07:29:23ZengKorean Child Neurology SocietyAnnals of Child Neurology2635-909X2635-91032024-10-0132423824410.26815/acn.2024.006331379Temporal Lobe Surgery in Pediatric Patients: From Temporal Lobe Epilepsy to Temporal Plus EpilepsyJun Chul Byun0Hye Eun Kwon1Hoon-Chul Kang2Joon Soo Lee3Heung Dong Kim4 Department of Pediatrics, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea Department of Pediatrics, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea Division of Pediatric Neurology, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea Division of Pediatric Neurology, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, KoreaPurpose Temporal lobe resection can be categorized as either temporal lobe epilepsy (TLE), which involves cortical resection confined to the temporal lobe, or temporal plus epilepsy (TPE), which entails temporal resection along with involvement of additional extratemporal regions. We compared these forms within a pediatric population. Methods We identified 136 patients who underwent temporal resection over a 17-year period and investigated the differences in the clinical profiles and seizure outcomes between TLE and TPE. Results Of the total sample, 110 patients (80.9%) presented with TLE and 26 (19.1%) with TPE. Significant differences were observed between the groups in age at seizure onset (TLE: 6.3 years, TPE: 0.9 years; P=0.001), age at epilepsy surgery (TLE: 14.2 years, TPE: 9.2 years; P=0.002), the proportion of patients with a history of infantile epileptic spasm syndrome (IESS) (TLE: 6 [5.5%], TPE: 8 [30.3%]; P<0.001), electroclinical presentation with IESS or Lennox-Gastaut syndrome (LGS) (TLE: 11 [10.0%], TPE: 13 [50.0%]; P<0.001), the presence of focal temporal hypometabolism on positron emission tomography (TLE: 74 [68.5%], TPE: 11 [44.0%], P=0.021), and the use of intracranial electroencephalogram monitoring (TLE: 58 [52.7%], TPE: 21 [80.8%]; P=0.009). Furthermore, multivariate analysis identified the epileptic presentation of IESS or LGS as a significant predictor of TPE (P=0.049). The rates of seizure outcomes of International League Against Epilepsy class 1–3 at 1 year of follow-up were 83.8% for the entire cohort, 89.1% for TLE, and 61.5% for TPE (P=0.002). Conclusion TPE appears to represent a substantial subset of pediatric temporal resections. The variation in seizure outcomes between groups underscores the importance of predicting TPE in advance, with implications for effective treatment planning.http://annchildneurol.org/upload/pdf/acn-2024-00633.pdfepilepsytemporal lobepediatrics |
| spellingShingle | Jun Chul Byun Hye Eun Kwon Hoon-Chul Kang Joon Soo Lee Heung Dong Kim Temporal Lobe Surgery in Pediatric Patients: From Temporal Lobe Epilepsy to Temporal Plus Epilepsy Annals of Child Neurology epilepsy temporal lobe pediatrics |
| title | Temporal Lobe Surgery in Pediatric Patients: From Temporal Lobe Epilepsy to Temporal Plus Epilepsy |
| title_full | Temporal Lobe Surgery in Pediatric Patients: From Temporal Lobe Epilepsy to Temporal Plus Epilepsy |
| title_fullStr | Temporal Lobe Surgery in Pediatric Patients: From Temporal Lobe Epilepsy to Temporal Plus Epilepsy |
| title_full_unstemmed | Temporal Lobe Surgery in Pediatric Patients: From Temporal Lobe Epilepsy to Temporal Plus Epilepsy |
| title_short | Temporal Lobe Surgery in Pediatric Patients: From Temporal Lobe Epilepsy to Temporal Plus Epilepsy |
| title_sort | temporal lobe surgery in pediatric patients from temporal lobe epilepsy to temporal plus epilepsy |
| topic | epilepsy temporal lobe pediatrics |
| url | http://annchildneurol.org/upload/pdf/acn-2024-00633.pdf |
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