The outcome of 11 children who had undergone temporal lobectomy for the treatment of intractable complex partial seizures is reported from the Royal Children’s Hospital, Melbourne, Australia. The average age at the time of surgery was 5 years 6 months (range, 1 to 9 years). The interval between onset of epilepsy and surgery averaged 3½ years. The cause of the epilepsy was mesial temporal sclerosis in 4, glioma in 5, dysplasia in 1, and chronic progressive encephalitis in 1. Four patients had had febrile convulsions lasting more than 15 minutes. Seven patients had behavior disorders preoperatively, including hyperactivity, rage reactions, and destructive aggressive tendencies. At 2 to 7 years follow-up after surgery eight patients were seizure-free, two had seizures reduced in frequency, and only one with encephalitis had not benefitted. Behavior was significantly improved in four of seven patients evaluated. Postoperative sequelae, including visual field defects and minor hemiparesis, occurred in four. [1]
COMMENT. These results are encouraging and should lead to more frequent referral of children with refractory epilepsies to our neurosurgical colleagues. The occurrence of febrile convulsions as antecedents of the complex partial seizures in 36% of this group of children invalidates reports that stress the benign nature of the febrile seizure and are opposed to prophylactic therapy.