TEMPORAL-LOBE EPILEPSY IN EARLY-CHILDHOOD

To explore the electroclinical features of temporal lobe epilepsy (TLE ) in early childhood, we studied results of video-EEG and other tests of 14 children aged 16 months to 12 years selected by seizure-free out come after temporal lobectomy. Four children had mesiotemporal scleros is, 1 had cortical dysplasia, and 9 had low-grade temporal neoplasms. The children had complex partial seizures (CPS) with symptomatology si milar to that of adults with TLE, including decreased responsiveness a nd automatisms. Automatisms tended to be simpler in the younger childr en, typically limited to lip smacking and fumbling hand gestures. Scal p/sphenoidal EEG showed anterior/inferior temporal interictal sharp wa ves and unilateral temporal seizure onset in the 4 children with mesio temporal sclerosis and in the child with cortical dysplasia, but EEG f indings in 9 children with low-grade temporal tumors were complex, inc luding multifocal interictal sharp waves or poorly localized or falsel y lateralized EEG seizure onset. In children without tumors, video-EEG was critical to localization of the epileptogenic zone for resection, but in patients with tumors video-EEG was less localizing and its mai n value was to confirm that the reported behaviors were epileptic seiz ures with semiology typical of temporal lobe onset.