Results of video-EEG, PET, MRI, and pathological findings in 14 children aged 16 months to 12 years who were seizure-free after temporal lobectomy are reported in a multicenter, international study at Cleveland, Singapore, Naples, and Helsinki. In 4 children with mesiotemporal sclerosis and in 1 with cortical dysplasia, EEG showed anterior/inferior temporal interictal sharp waves and unilateral temporal seizure onset. In 9 with low- grade temporal neoplasms, the EEG findings were complex, including multifocal interictal sharp waves or falsely lateralized EEG seizure onset. Video-EEG recording was most useful for localization of the epileptogenic zone for resection in those without tumors. In patients with tumors, video-EEG confirmed the epileptic nature of the complex partial seizures but was of less localizing value. [1]

COMMENT. Three of 4 patients in this study with mesiotemporal sclerosis had a history of infantile compex febrile seizures compared with none of 10 with tumor or cortical dysplasia. An excellent outcome after temporal surgical resection in a group of 19 patients with mesiotemporal sclerosis following prolonged febrile convulsions is reported from the Montreal Neurological Institute [2]. The response and seizure control in this group was significantly better than in those without antecedent febrile convulsions.

In 15 children with temporal lobe epilepsy, aged 7-14 years, studied at the Royal Children’s Hospital, Melbourne, Australia, ictal SPECT provided reliable lateralizing information to confirm that obtained from surface EEG and MRI. In 4, ictal SPECT was superior to ictal EEG in localizing value. [3]

Anterior left temporal lobectomy and seizure control had an apparent beneficial effect on illogical thinking in a group of 7 children treated for intractable temporal lobe epilepsy at the University of California at Los Angeles. [4]