The results of temporal lobectomy in 16 children under the age of 12 years who had intractable seizures of temporal lobe origin are reported from the Miami Children’s Hospital, Florida. All had seizures for at least 2 years despite multiple antiepileptic drugs. Structural lesions were demonstrated by neuroimaging in 11 patients. At follow-up from 1 to 4 years 11 children were seizure free, 3 were 90% improved, 1 was 50% improved and 1 was unchanged. Of 9 families contacted 7 reported substantial improvement in the child’s psychosocial function. Neuropathological abnormalities identified in all children showed findings consistent with disordered neuronal migration in 7, tuberous sclerosis in 1, and mesial temporal sclerosis only in 2 children. [1]
COMMENT. Anterior temporal lobectomy tailored according to the extent of the lesion and epileptogenic field may be beneficial in preadolescent children with medically refractory seizures. Compared to adults, children undergoing temporal lobectomy have a higher incidence of abnormalities of neurogenesis and lesions that are poorly circumscribed and often widespread.