Abstracts

RATIONALE: In the literature, typically cryptogenic temporal lobe epilepsy (TLE) begins in childhood around the age of 10, in patients with febrile convulsions followed by a free interval. The aim was to study a group of subjects with early onset TLE compared to a second group with usual age at onset TLE.
METHODS: We considered retrospectively all consecutive subjects who underwent temporal resection for cryptogenic TLE between 1993 and 1998 (by a total of 105 patients). We selected a first group (18 patients) with age at onset inferior to 4 years and a second group (14 patients) with age at onset between 8 and 12. We compared in the 2 groups past history, clinical data, neuropsychological evaluation, ictal video-EEG, Single Photon Emission Computed Tomography (SPECT), surgical data and outcome.
RESULTS: Mean age at surgery was 31.8 years (SD 6.22) in the first group, 30.7 (SD 8.8) in the second. Childhood febrile convulsions, familial epilepsy history, status epilepticus were more frequent in the early onset group; febrile convulsions were significantly more frequent in the first group. Frequency of seizures, occurrence of secondary generalized seizures, intellectual quotient, ictal SPECT were not different between the 2 groups. The ictal and post-ictal clinical features were similar in the 2 groups but stereotactic implantation of depth electrodes was more frequently performed in the first group. Extent of resection and surgical outcome were similar.
CONCLUSIONS: Early onset TLE seems to be not different from TLE beginning in late childhood. It could pose the question of the free interval (may seizures be overlooked?). This have to be confirmed in a larger population.