Effects of temporal lobectomy on consciousness-impairing and consciousness-sparing seizures in children

  title={Effects of temporal lobectomy on consciousness-impairing and consciousness-sparing seizures in children},
  author={Dario J. Englot and Martin Rutkowski and Michael E. Ivan and Peter P. Sun and Rachel A. Kuperman and Edward F. Chang and Nalin Gupta and Joseph E. Sullivan and Kurtis I. Auguste},
  journal={Child's Nervous System},
PurposeMost children with medically refractory temporal lobe epilepsy (TLE) become seizure free after temporal lobectomy, but some individuals continue to seize. As studies of temporal lobectomy typically focus on seizure freedom, the effect of surgery on seizure type and frequency among children with persistent seizures is poorly understood. Seizures which impair consciousness are associated with increased morbidity compared to consciousness-sparing seizures.MethodsA retrospective cohort study… Expand
4 Citations
Rates and predictors of seizure freedom in resective epilepsy surgery: an update
Overall, resective epilepsy surgery leads to seizure freedom in approximately two thirds of patients with intractable temporal lobe epilepsy and about one half of individuals with focal neocortical epilepsy, although only the former observation is supported by class I evidence. Expand
Thirty-day non-seizure outcomes following temporal lobectomy for adult epilepsy
Rates of acute morbidity and mortality following TL procedures using a validated national database can be used both to assist with patient selection as well as patient counseling prior to surgery. Expand
Initiating an epilepsy surgery program with limited resources in Indonesia
The overall median survival times for patients with focal impaired awareness seizures (FIAS), focal to bilateral tonic–clonic seizures and generalized tonic- Clonic seizures were 9, 11 and 11 years (95% CI: 8.170–9.830, 10.265–14.735), respectively, with p  = 0.04. Expand
Altered expression of signaling pathways regulating neuronal excitability in hippocampal tissue of temporal lobe epilepsy patients with low and high seizure frequency
It is inferred that enhanced expression of a signaling cascade promoting synaptic downscaling may have played a key role in maintaining a higher seizure threshold in the LSF cohort, and that therapeutic approaches targeting synaptic scaling pathways may aid in the treatment of seizures in TLE. Expand


Seizure outcomes after temporal lobectomy in pediatric patients.
Pediatric patients with medically refractory TLE should be referred to a comprehensive pediatric epilepsy center for surgical evaluation, and favorable outcomes may be predicted by lesional epilepsy etiology, abnormal MRI, and lack of generalized seizures. Expand
Impact of pediatric epilepsy surgery on intellectual efficiency.
The results suggest that the success of the epilepsy surgery in childhood when the seizure control is achieved may also provide an improvement in the Performance Scale whereas the seizure maintenance may worsen the Verbal Scale. Expand
Consciousness and epilepsy: why are complex-partial seizures complex?
The laboratory has proposed the "network inhibition hypothesis," in which seizure activity propagates to subcortical regions necessary for cortical activation, allowing the cortex to descend into an inhibited state of unconsciousness during complex-partial temporal lobe seizures. Expand
Cognitive Outcomes in Patients with Chronic Temporal Lobe Epilepsy
Cognitive impairment is frequent in temporal lobe epilepsy, but deficits in extratemporal lobe functions and global intelligence are also found, and better baseline performance, younger age, cerebral plasticity, and good mental reserve capacities are associated with a better outcome. Expand
Discontinuation of antiepileptic drugs after pediatric epilepsy surgery.
Surgical outcome and need for antiepileptic drugs after temporal and extratemporal lobe resection were retrospectively reviewed for 80 pediatric patients from the Comprehensive Epilepsy Program at the University of Alberta. Expand
Neuropsychological characteristics of the syndrome of mesial temporal lobe epilepsy.
Distinct neuropsychological features of spared, compromised, and laterality-specific cognitive impairments characterize the syndrome of MTLE, a surgically remediable epileptic syndrome defined by the presence of hippocampal sclerosis. Expand
Long-term outcomes of epilepsy surgery in school-aged children with partial epilepsy.
Surgical outcomes of school-aged children with intractable partial epilepsy from China and those from developed countries are compared, surgical candidate criteria are introduced, and significant differences were evident in mean changes of full intelligence quotient, full memory quotients, and overall quality of life between patients with preoperative low intelligence quotients. Expand
Quality of life after surgery for intractable partial epilepsy in children: A cohort study with controls
The data indicate that epilepsy surgery for partial seizures in children is associated with better quality of life as compared to children with intractable epilepsy who are not operated on, and suggest that in those who achieve seizure freedom normal QOL may at least potentially be possible. Expand
Mesial temporal lobe epilepsy: How do we improve surgical outcome?
It may be time to view MTLE as a group of closely related syndromes with variable type and extent of histopathology, which may lead to identifying the appropriate subgroups that will require different diagnostic and surgical approaches to improve surgical outcomes. Expand
Outcomes of epilepsy surgery in adults and children
The outcomes of surgery in adults and children with epilepsy are considered and studies of neurological and cognitive sequelae, psychiatric and behavioural outcomes, and overall health-related quality of life are reviewed. Expand