PATHOLOGY OF TEMPORAL LOBECTOMY FOR REFRACTORY SEIZURES IN CHILDREN -REVIEW OF 20 CASES INCLUDING SOME UNIQUE MALFORMATIVE LESIONS

Significant pathological abnormalities were encountered in a series of 20 temporal lobectomies in children with intractable complex partial seizures. In particular, ''dual pathology'' (mesial temporal sclerosis with other lesions) was found rather than mesial temporal sclerosis a s the only lesion. Unusual pathological findings included capillary pe netration of neurons in a neuronal heterotopia in one patient, and foc i of extensive cortical disorganization in some cases of mixed tumors and gangliogliomas. A high proportion of neuronal migration disorders was also seen with overlapping pathological features between cortical dysplasia and tuberous sclerosis. In this correlative clinical, radiol ogical, electroencephalographic, and pathological study, some of the p athological lesions in children did not fit the classical categories o f neoplasia and malformation and transitional forms were rarely encoun tered.