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Original ArticleOpen Access
Temporal Lobectomy for Intractable Complex Partial Seizures in Pediatric Patients
Visudhiphan P 
,
Bunyaratavej S ,
Visudtibhan A ,
Chiemchanya S ,
Laothamatas J ,
Samvivad P ,
Janwityanujit T
,
Bunyaratavej S ,
Visudtibhan A ,
Chiemchanya S ,
Laothamatas J ,
Samvivad P ,
Janwityanujit T Fourteen children, 7 boys and 7 girls, who failed conventional medical treatment for
complex partial seizures underwent anterior temporal lobectomy at Ramathibodi Hospital,
Bangkok, Thailand, from July 1993 to June 1998. The mean age at onset of patients was 6.7 years
old and the mean duration of seizures before surgery was 6.4 years. The age of patients at surgery
ranged from 8 to 22 years old. These patients had had limited presurgical evaluation which
included video-electroencephalography (EEG), magnetic resonance imaging (MRI) and single
photon emission computed tomography (SPECT). All patients demonstrated concordant among
clinical symptoms, EEG, MRI and SPECT on the same side of the temporal lobe. Ten and 4 patients
had unilateral and bilateral temporal lobe lesions respectively. The operations were done on the left
in 10 patients and on the right in 4 patients. Seizure free after 1/2 - 5 years of follow-up was obtained
in 70 per cent of patients which included 9 of 10 patients with unilateral temporal lesion and I of 4
patients with bilateral temporal lesions. The rest of the patients showed marked reduction of
seizures except for one patient with bilateral lesions in whom only 50-70 per cent reduction was
obtained. Marked improvement of behaviour was also observed in 70 per cent of patients. Resected
brain specimens revealed mesial temporal sclerosis, gliosis, tumors and cavernoma in 6, 5, 2 and
1 patients respectively.
Key word : Epilepsy\ Temporal Lobe Epilepsy, Intractable Complex Partial Seizure, Temporal Lobectomy
complex partial seizures underwent anterior temporal lobectomy at Ramathibodi Hospital,
Bangkok, Thailand, from July 1993 to June 1998. The mean age at onset of patients was 6.7 years
old and the mean duration of seizures before surgery was 6.4 years. The age of patients at surgery
ranged from 8 to 22 years old. These patients had had limited presurgical evaluation which
included video-electroencephalography (EEG), magnetic resonance imaging (MRI) and single
photon emission computed tomography (SPECT). All patients demonstrated concordant among
clinical symptoms, EEG, MRI and SPECT on the same side of the temporal lobe. Ten and 4 patients
had unilateral and bilateral temporal lobe lesions respectively. The operations were done on the left
in 10 patients and on the right in 4 patients. Seizure free after 1/2 - 5 years of follow-up was obtained
in 70 per cent of patients which included 9 of 10 patients with unilateral temporal lesion and I of 4
patients with bilateral temporal lesions. The rest of the patients showed marked reduction of
seizures except for one patient with bilateral lesions in whom only 50-70 per cent reduction was
obtained. Marked improvement of behaviour was also observed in 70 per cent of patients. Resected
brain specimens revealed mesial temporal sclerosis, gliosis, tumors and cavernoma in 6, 5, 2 and
1 patients respectively.
Key word : Epilepsy\ Temporal Lobe Epilepsy, Intractable Complex Partial Seizure, Temporal Lobectomy
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