The use of temporal lobectomy for the treatment of intractable complex partial seizures of temporal lobe origin has a long and successful history. When appropriately applied in children, excellent seizure control and neurodevelopmental progress are expected. This article reviews patient selection, evaluating the surgical procedure and outcome for temporal lobectomy, specifically in the pediatric population.

Keywords:
Epilepsy, Temporal lobe, Surgery, Complex partial seizures
1.
National Commission for the Control of Epilepsy and its Consequences: Plan for a Nationwide Action on Epilepsy, (1977) DHEW Publications No. (NIH) 78–276.
2.
Fried I: Anatomic temporal lobe resections for temporal lobe epilepsy; in Silbergeld DL, Ojemann GA (eds): Epilepsy Surgery, Neurosurgery Clinics of North America. Philadelphia, Saunders, 1993, vol 4, pp 233–243.
3.
Hauser WA: Seizure disorders: The changes with age. Epilepsia 1992;33:S6–S14.
4.
Peacock WJ, Comair Y, Chugani HT, Shewmon DA, Shields WD: Epilepsy surgery in childhood; in Luders H (ed): Epilepsy Surgery. New York, Raven Press, 1991, pp 589–598.
5.
Lindsey J, Ounsted C, Richards P: Long-term outcome in children with temporal lobe seizures: Social outcome and childhood factors. Dev Med Child Neurol 1979;21:630–636.
6.
Shields WD, Peacock WJ, Roper SN: Surgery for epilepsy: Special pediatric considerations; in Silbergeld DL, Ojemann GA (eds): Epilepsy Surgery, Neurosurgery Clinics of North America. Philadelphia, Saunders, 1993, vol 4, pp 301–310.
7.
Babb TL, Brown WJ: Pathological findings in epilepsy; in Engel JE (ed): Surgical Treatment of the Epilepsies. New York, Raven Press, 1987, pp 511–540.
8.
Davies KG, Hermann BP, Dohan FC Jr, Foley KT, Bush AJ, Wyler AR: Relationship of hippocampal sclerosis to duration and age of onset of epilepsy, and childhood febrile seizures in temporal lobectomy patients. Epilepsy Res 1996;24:119–126.
9.
Scheibel ME, Scheibel AB: Hippocampal pathology in temporal lobe epilepsy: A Golgi survey; in Brazier MAB (ed): Epilepsy: Its Phenomena in Man. New York, Academic Press, 1973, pp 311–337.
10.
Grattan-Smith JD, Harvey AS, Desmond PM, Chow CW: Hippocampal sclerosis in children with intractable temporal lobe epilepsy: Detection with MR imaging. Am J Roentgenol 1993;161:1045–1048.
11.
Engel J, Kuhl DE, Phelps ME: Comparative localization of epileptic foci in parietal epilepsy by PET and EEG. Ann Neurol 1982;12:529–537.
12.
Rausch R, Babb TL, Engel J: Memory following intracarotid amobarbital injection contralateral to hippocampal damage. Arch Neurol 1989;46:783–788.
13.
Lombardi D, Marsh R, de Tribolet N: Low grade glioma in intractable epilepsy: Lesionectomy versus epilepsy surgery. Acta Neurochir Suppl (Wien) 1997;68:70–74.
14.
Adelson PD, Peacock WJ, Chugani HT, Comair YG, Vinters HV, Shields WD, Shewmon DA: Temporal and extended temporal resections for the treatment of intractable seizures in early childhood. Pediatr Neurosurg 1992;18:169–178.
15.
Jay V, Becker LE, Otsubo H, Hwang PA, Hoffman HJ, Harwood-Nash D: Pathology of temporal lobectomy for refractory seizures in children: Review of 20 cases including some unique malformative lesions. J Neurosurg 1993;79:53–61.
16.
Chugani HT, Shields WD, Shewmon DA, Olson DM, Phelps ME, Peacock WJ: Infantile spasms. I. PET identifies focal cortical dysgenesis in cryptogenic cases for surgical treatment. Ann Neurol 1990;27:406–413.
17.
Chugani HT: PET in preoperative evaluation of intractable epilepsy. Pediatr Neurol 1994;9:411–413.
18.
Mattson RH, Cramer JA, Collins JF: Comparison of carbamazepine, phenobarbital, phenytoin, and premadone in partial and secondarily generalized tonic-clonic seizures. N Engl J Med 1985;313:145–151.
19.
Penry JK: Perspectives in complex partial seizures. Adv Neurol 1975;11:1–11.
20.
Fish DR, Smith SJ, Quesney LF, Andermann F, Rasmussen T: Surgical treatment of children with medically intractable frontal or temporal lobe epilepsy: Results and highlights of 40 years experience. Epilepsia 1993;34:244–247.
21.
Falconer MA: Neurosurgery; in Logue V (ed): Operative Surgery. Philadelphia, Lippincott, 1971, vol 14, p 142.
22.
Meyer FB, Marsh WR, Laws ER, Sharbrough FW: Temporal lobectomy in children with epilepsy. J Neurosurg 1986;64:371–376.
23.
Rasmussen T: Surgical aspects; in Blaugh ME, Rapin I, Kinsbourne M (eds): Topics in Child Neurology (First International Congress of Child Neurology). Jamaica, Spectrum, 1977, pp 143–157.
24.
Rich KM, Goldring S, Gado M: Computed tomography in chronic seizure disorder caused by glioma. Arch Neurol 1985;42:26–27.
25.
Wyllie E, Chee M, Granstrom ML, DelGiudice E, Estes M, Comair Y, Pizzi M, Kotagal P, Bourgeois B, Luders H: Temporal lobe epilepsy in early childhood. Epilepsia 1993;34:859–868.
26.
Blume WT, Girvin JP, McLachlan RS, Gilmore BE: Effective temporal lobectomy in childhood without invasive EEG. Epilepsia 1997;38:164–167.
27.
Laxer KD, Garcia PA: Imaging criteria to identify the epileptic focus; in Silbergeld DL, Ojemann GA (eds): Epilepsy Surgery, Neurosurgery Clinics of North America. Philadelphia, Saunders, 1993, vol 4, pp 199–209.
28.
Otsubo H, Hwang PA, Hoffman HJ, Becker LE, Gilday DL, Chuang SH, Harwood-Nash D: Neuro-imaging studies in children with temporal lobectomy. Childs Nerv Syst 1995;11:281–287.
29.
Li LM, Cendes F, Antel SB, Andermann F, Serles W, Dubeau F, Olivier A, Arnold DL: Prognostic value of proton magnetic resonance spectroscopic imaging for surgical outcome in patients with intractable temporal lobe epilepsy and bilateral hippocampal atrophy. Ann Neurol 2000;47:195–200.
30.
Hubesch B, Marineier DS, Hetherington HP, Twieg DB, Winer MW: Clinical MRS studies of the brain. Invest Radiol 1989;24:1039–1042.
31.
Olson DM, Chugani HT, Shewmon DA, Phelps ME, Peacock WJ: Electrocorticographic confirmation of focal positron emission tomographic abnormalities in children with intractable epilepsy. Epilepsia 1990;31:731–739.
32.
Adelson PD, Black PM, Kramer U, Rockoff MA, Riviello J, Helmers SL, Mikati M, Holmes G, Madsen JR: The use of grid and strip electrodes to identify a seizure focus in children. Pediatr Neurosurg 1995;22:174–180.
33.
Chugani HT, Phelps ME, Shewmon DA, Barnes D: Cerebral glucose utilization in intractable neonatal seizures and the developing brain; in Wasterlain G, Vert P (eds): Neonatal Seizures. New York, Raven Press, 1990.
34.
Chugani HT, Shewmon DA, Peacock WJ, Shields WD, Mazziota JC, Phelps ME: Surgical treatment of intractable neonatal-onset seizures: The role of positron emission tomography. Neurology 1988;38:1178–1188.
35.
Duncan JD, Moss SD, Bandy DJ, Manwaring K, Kaplan AM, Reiman EM, Chen K, Lawson MA, Wodrich DL: Use of positron emission tomography for pre-surgical localization of eloquent brain areas in children with seizures. Pediatr Neurosurg 1997;26:144–156.
36.
Theodore WH, Sato S, Kufta C, Balish MB, Bromfield EB, Leiderman DB: Temporal lobectomy for uncontrolled seizures: The role of positron emission tomography. Ann Neurol 1992;32:789–794.
37.
Debets RM, Sadzot B, Van Isselt JW: Is ‘c flumazenil’ PET superior to 18FDG PET and 123I-iomazenil SPECT in pre-surgical evaluation of temporal lobe epilepsy? J Neurol Neurosurg Psychiatry 1997;62:141–150.
38.
Franck G, Sadzot B, Salmon E, Depresseux JC, Grisar T, Peters JM, Guillaume M, Quaglia L, Delfiore G, Lamotte D: Regional cerebral blood flow and metabolic rates in human focal epilepsy and status epilepticus. Adv Neurol 1986;44:935–948.
39.
Homan RW, Devous MD, Stokely EM, Bonte FJ: Correlation of EEG findings and cerebral blood flow in patients with partial seizures. Neurology 1984;34:124–125.
40.
Ochs RF, Yamamoto L, Gloor P, Tyler J, Feindel W: Correlation between positron emission tomography measurement of glucose metabolism and oxygen utilization with focal epilepsy. Neurology 1984;34:125.
41.
Mitsuyoshi I, Tamaki K, Okuno T, Mutoh K, Iwasaki Y, Konishi J, Mikawa H: Regional cerebral blood flow in diagnosis of childhood onset partial epilepsy. Brain Dev 1993;15:97–102.
42.
Spanaki MV, Zubal IG, MacMullan J, Spencer SS: Peri-ictal SPECT localization verified by simultaneous intracranial EEG. Epilepsia 1999;40:267–274.
43.
Rowe CC, Berkovic SF, Austin MC, McKay WJ, Bladin PF: Patterns of postictal cerebral blood flow in temporal lobe epilepsy: Qualitative and quantitative analysis. Neurology 1991;41:1096–1103.
44.
Rowe CC, Berkovic SF, Sia ST, Austin M, McKay WJ, Kalnins RM, Bladin PF: Location of epileptic foci with post ictal single photon emission computed tomography. Ann Neurol 1989;26:660–668.
45.
Harvey AS, Bowe JM, Hopkins IJ, Shield LK, Cook DJ, Berkovic SF: Ictal 99mTc-HMPAO single photon emission computed tomography in children with temporal lobe epilepsy. Epilepsia 1993;34:869–877.
46.
Lynch BJ, O’Tuama L, Holmes GL, Treves ST: Correlation of Tc99-m HMPAO SPECT with EEG monitoring: Prognostic value for outcome of epilepsy surgery in children. Ann Neurol 1992;32:433–434.
47.
Spanaki MV, Spencer SS, Wisniewski G, MacMullan J, Secby IJ, Zubal IG: Evaluation and localization of post-ictal blood flow changes in partial seizures demonstrated by SPECT: Use of quantitative difference images. J Epilepsy 1998;11:25–33.
48.
Sperling MR, O’Connor MJ: Comparison of depth subdural electrodes in recording temporal lobe seizure. Neurology 1989;39:1497–1504.
49.
Duchowny MS: Surgery for intractable epilepsy: Issues and outcome. Pediatrics 1989;84:886–894.
50.
Rasmussen T: Results of cortical resection in focal epilepsy. Advances in Epileptology. 15th Epilepsy International Symposium. New York, Raven Press, 1984, pp 449–455.
51.
Penfield W, Flanigin H: Surgical therapy of temporal lobe seizures. Arch Neurol 1950;64:491–500.
52.
Spencer DD, Spencer SS, Mattson RH, Wiliamson PD, Novelly RA: Access to the posterior medial temporal lobe structures and the surgical treatment of temporal lobe epilepsy. Neurosurgery 1984;15:667–670.
53.
Adelson PD: Temporal lobectomy in children; in Albright AL, Pollack IF, Adelson PD (eds): Operative Techniques in Pediatric Neurosurgery. New York, Thieme Medical Publishers, 2000.
54.
Silbergeld DL, Ojemann GA: The tailored temporal lobectomy; in Silbergeld DL, Ojemann GA (eds): Epilepsy Surgery, Neurosurgery Clinics of North America. Philadelphia, Saunders, 1993, vol 4, pp 273–282.
55.
Duchowny M, Levin B, Jayakar P, Rensick T, Alvarez L, Morrison G, Dean P: Temporal lobectomy in early childhood. Epilepsia 1992;33:298–303.
56.
Awad IA, Katz A, Hahn JF, Kong AK, Ahl J, Luders H: Extent of resection in temporal lobectomy for epilepsy. I. Interobserver analysis and correlation with seizure outcome. Epilepsia 1989;30:756–762.
57.
Davidson S, Falconer MA: Outcome of surgery in 40 children with temporal lobe epilepsy. Lancet 1973;i:1260–1263.
58.
Van Buren JM: Complications of surgical procedures in the diagnosis and treatment of epilepsy; in Ebgel J (ed): Surgical Treatment of the Epilepsies. New York, Raven Press, 1987, pp 465–475.
59.
Pilcher WH, Rusyniak WG: Complications of epilepsy surgery; in Silbergeld DL, Ojemann GA (eds): Epilepsy Surgery, Neurosurgery Clinics of North America. Philadelphia, Saunders, 1993, vol 4, pp 311–325.
60.
Penfield W, Lende R, Rasmussen T: Manipulation hemiplegia. J Neurosurg 1961;18:760.
61.
Girvin JP: Complications of epilepsy surgery; in Luders H (ed): Epilepsy Surgery. New York, Raven Press, 1991, pp 653–660.
62.
Rausch R, Crandall PH: Psychological status related to surgical control of temporal lobe seizures. Epilepsia 1982;23:191–202.
63.
Caplan R, Guthrie D, Shields WD, Peacock WJ, Vinters HV, Yudovin S: Communication deficits in children undergoing temporal lobectomy. J Am Acad Child Adolesc Psychiatry 1993;32:604–611.
64.
Williams J, Griebel ML, Sharp GB, Boop FA: Cognition and behavior after temporal lobectomy in pediatric patients with intractable epilepsy. Pediatr Neurol 1998;19:189–194.
65.
Westerveld M, Sass KJ, Chelune GJ, Hermann BP, Barr WB, Loring DW, Strauss E, Trenerry MR, Perrine K, Spencer DD: Temporal lobectomy in children: Cognitive outcome. J Neurosurg 2000;92:24–30.
66.
Dlugos DJ, Moss EM, Duhaime AC, Brooks-Kayal AR: Language-related cognitive declines after left temporal lobectomy in children. Pediatr Neurol 1999;21:444–449.
67.
Szabo CA, Wyllie E, Stanford LD, Geckler C, Kotagal P, Comair YG, Thornton AE: Neuropsychological effect of temporal lobe resection in preadolescent children with epilepsy. Epilepsia 1998;39:814–819.
68.
Helmstaedter C, Elger CE: Functional plasticity after left anterior temporal lobectomy: Reconstitution and compensation of verbal memory functions. Epilepsia 1998;39:399–406.
© 2001 S. Karger AG, Basel
2001
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