Surgical treatment for temporal lobe epilepsy in childhood

We retrospectively analyzed 5 children (11 ≃ 15 year) with intractable temporal lobe epilepsy(TLE) who underwent the anterior temporal lobectomy with hippocampectomy. Cases 1 ≃ 3 had medial TLE (MTLE) with histologically verified hippocampal sclerosis, Case 4 had lateral TLE, and Case 5 had MTLE with old hemorrhagic lesion in the lateral temporal lobe. In Cases 3 ≃ 5, chronic invasive electrocorticography recording using subdural electrodes was obtained, while in Cases 1 and 2, the epileptogenic region was defined by noninvasive preoperative evaluation. Postoperatively, Cases 1 ≃ 3 became seizure free. All patients had psychosocial problems after the onset of their epilepsy, which was not improved even after the surgical control of epilepsy. Since most patients had morphological change and perfusional and metabolic disturbance outside the hippocampus at the time of surgery, earlier surgical consideration may be necessary.