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Childhood onset temporal lobe epilepsy: Beyond hippocampal sclerosis

A. Mühlebner, M. Breu, G. Kasprian, MT. Schmook, H. Stefanits, T. Scholl, S. Samueli, G. Gröppel, A. Dressler, D. Prayer, T. Czech, JA. Hainfellner, M. Feucht,

. 2016 ; 20 (2) : 228-35. [pub] 20151231

Jazyk angličtina Země Anglie, Velká Británie

Typ dokumentu časopisecké články, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc16027732

OBJECTIVE: Hippocampal Sclerosis (HS) is widely recognized as a significant underlying cause of drug-resistant temporal lobe epilepsy (TLE) in adults. In contrast, HS is a rare finding in pediatric surgical series, and a higher incidence of HS associated with cortical dysplasia (i.e. FCD type IIIa according to the new ILAE classification) than in adult series has been reported. Data about the electro-clinical characteristics of this subgroup are scarce. METHODS: We studied 15 children and adolescents with drug-resistant TLE and HS who had anterior temporal lobe resection at our center with regard to electroclinical characteristics, MRI features and histopathology. Children in whom histopathology was consistent with Focal Cortical Dysplasia (FCD) type IIIa (n = 7) were compared with those who had HS only (n = 8). RESULTS: Clinical characteristics associated with this highly selective subset of patients with FCD type IIIa were: the presence of febrile seizures during infancy, a shorter duration of active epilepsy and a lower age at epilepsy surgery. In addition, there were non-significant trends towards more extended abnormalities on both EEG and neuroimaging. We were, however, not able to find group differences with respect to neuropathologic subtyping of the HS. CONCLUSION: We present the first detailed description and comprehensive data analysis of children with FCD type IIIa. According to our results, this patient group seems to show a distinct clinical phenotype.

Citace poskytuje Crossref.org

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$a OBJECTIVE: Hippocampal Sclerosis (HS) is widely recognized as a significant underlying cause of drug-resistant temporal lobe epilepsy (TLE) in adults. In contrast, HS is a rare finding in pediatric surgical series, and a higher incidence of HS associated with cortical dysplasia (i.e. FCD type IIIa according to the new ILAE classification) than in adult series has been reported. Data about the electro-clinical characteristics of this subgroup are scarce. METHODS: We studied 15 children and adolescents with drug-resistant TLE and HS who had anterior temporal lobe resection at our center with regard to electroclinical characteristics, MRI features and histopathology. Children in whom histopathology was consistent with Focal Cortical Dysplasia (FCD) type IIIa (n = 7) were compared with those who had HS only (n = 8). RESULTS: Clinical characteristics associated with this highly selective subset of patients with FCD type IIIa were: the presence of febrile seizures during infancy, a shorter duration of active epilepsy and a lower age at epilepsy surgery. In addition, there were non-significant trends towards more extended abnormalities on both EEG and neuroimaging. We were, however, not able to find group differences with respect to neuropathologic subtyping of the HS. CONCLUSION: We present the first detailed description and comprehensive data analysis of children with FCD type IIIa. According to our results, this patient group seems to show a distinct clinical phenotype.
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$a Breu, Markus $u Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: markus.breu@meduniwien.ac.at.
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$a Kasprian, Gregor $u Department of Radiology, Medical University Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: gregor.kasprian@meduniwien.ac.at.
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$a Schmook, Maria T $u Department of Radiology, Medical University Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: maria.schmook@meduniwien.ac.at.
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$a Stefanits, Harald $u Department of Neurosurgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria; Institute of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: herald.stefanits@meduniwien.ac.at.
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$a Scholl, Theresa $u Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria; Institute of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: theresa.scholl@meduniwien.ac.at.
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$a Samueli, Sharon $u Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: sharon.samueli@meduniwien.ac.at.
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$a Gröppel, Gudrun $u Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: gudrun.groeppel@meduniwien.ac.at.
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$a Dressler, Anastasia $u Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: anastasia.dressler@meduniwien.ac.at.
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$a Prayer, Daniela $u Department of Radiology, Medical University Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: daniela.prayer@meduniwien.ac.at.
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$a Czech, Thomas $u Department of Neurosurgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: thomas.czech@meduniwien.ac.at.
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$a Hainfellner, Johannes A $u Institute of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: johann.hainfellner@meduniwien.ac.at.
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$a Feucht, Martha $u Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. Electronic address: martha.feucht@meduniwien.ac.at.
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