Mesial temporal epilepsy in childhood: a review of ten cases.

Background.- Mesio-temporal sclerosis is a frequent and probably underestim ed cause of resistant temporal epilepsy in childhood. Patients and methods. - Ten patients originating from West and North-East F rance are reported in this retrospective study. They were referred for part ial temporal epilepsy which had begun between the ages of 3.5 and 15 years. Mesio-temporal sclerosis was diagnosed on MRI (ten cases) and on neuropath ological examination (three cases). Results. - Complex partial seizures were noted in all patients, with most f requently fear, abnormal epigastric perception and oro-alimentary automatis ms. Social and educationnal issues were altered due to frequent seizures an d mnesic disturbances. An initial event, always a complex febrile seizure, was found in six patients. MRI study showed in all patients unilateral hipp ocampal atrophy and/or an increase in hippocampal T2 signal intensity on co ronal sections. Ictal EEG showed homolateral temporal seizures sin times. H ippocampo-amygdalectomy was performed in three patients with a good outcome . Conclusion. - Epilepsy associated with mesio-temporal sclerosis belongs t o intractable epilepsy in childhood. Early recognition of its symptoms woul d allow early pre-operative assessment in order to minimize developmental d efects due to continuing epilepsy, and adverse cognitive effects of anti-ep ileptics. (C) 1999 Elsevier, Paris.