The outcome of 22 patients with onset of complex partial seizures (CPS) in early childhood and treated by anterior temporal lobectomy after intervals varying from three to 28 years, is reported from the Epilepsy Research Center, Baylor College of Medicine, Houston, TX. All patients showed improved seizure control, the majority having a greater than 95% reduction in seizure frequency. Psychosocial, behavioral, and educational problems occurred more frequently in patients whose surgery was delayed until adult life. Neuropathologic abnormalities were found in both the mesial and lateral portions of the temporal lobe. Mesial abnormalities included the classical Ammon’s horn sclerosis and ganglioglioma. All the brain specimens showed congenital malformations or “microdysgenesis”. The authors considered surgery, performed soon after medical intractibility has been determined, may limit the problems associated with prolonged uncontrolled seizures. [1]

COMMENT. In these patients with seizure onset between two and ten years of age Ammon’s horn sclerosis occurred in 16 of the 22 patients. This finding contrasted with the absence of hippocampal sclerosis in patients with seizures beginning in infancy. [2]