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The typical features of mesial temporal lobe epilepsy with hippocampal sclerosis in children

Purpose. The aim of this study is to report on a group of 30 children with the diagnosis of mesial temporal lobe epilepsy (MTLE) and a magnetic resonance imaging (MRI) evidence of hippocampal sclerosis (HS), with special emphasis on electroclinical features, surgical treatment and prognosis. Material and methods. The patient’s fi les were retrospectively analyzed. All children underwent a comprehensive presurgical evaluation. We assessed age dependency of different clinical symptoms. The postsurgical outcome was classified using the Engel scale. Results. 11 cases had a personal history of febrile seizure. The patient’s seizure semiology contained a group of symptoms that are age dependent. Young children presented a predominance of motor arrest, autonomic signs and rare reported auras. In older children and adolescents, the seizure semiology became more elaborated with the presence of aura, emotional expressions, automatisms and motor lateralized signs. The presurgical evaluation confirmed the epileptic focus similar with the MRI localization of hippocampal sclerosis. 20 cases received the surgical treatment and 14 patients (70%) disclosed the postoperative seizure outcome in class I Engel (free of disabling seizures). Conclusions. MTLE-HS is a clearly define epileptic syndromic entity and the accurate diagnosis of patients that presented the onset in childhood and adolescence has a great influence on the therapeutic decision of their epilepsy.