Foramen ovale electrodes in the preoperative evaluation of temporal lobe epilepsy in children.

• PURPOSE: Foramen ovale electrodes (FOEs) can localize the epileptogenic zone in adults with mesial temporal lobe epilepsy (TLE). Our aim was to investigate the feasibility and safety of using FOEs to investigate refractory TLE in children. METHODS: Thirty-eight children with seizure semiology and video-EEG (electroencephalography) consistent with medically refractory TLE, and/or the presence of a lesion in the temporal lobe, had FOEs inserted. Complications occurring during the monitoring and up to 3 months after surgery and the long-term seizure outcome were registered. RESULTS: Forty electrodes were placed in 38 patients. The mean age of the patients was 9.8 years (range 2.3-15.4 years). FOEs confirmed a unilateral mesial temporal lobe seizure onset in 14 patients, onset in both FOEs and lateral electrodes in two patients, and onset in the anterior temporal electrodes in only one patient. Six patients had seizures recorded but were not considered surgical candidates; four patients had no seizures recorded, and 11 patients were further investigated with depth electrodes. One patient (2.6%) developed a hematoma in the cheek, and in two patients the electrodes were extracranial but could still be used for recording. Twenty-eight children had a temporal resection; 25 were Engel class I at follow-up. DISCUSSION: FOEs are safe to use in children and provide valuable information on the mesial temporal lobe structures in the preoperative investigation of pediatric TLE. Patient selection for FOE investigation is, however, essential for a conclusive result.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Fysiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Physiology (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Nyckelord

Adolescent

Age Factors

Child

Child

Preschool

Electrodes

Implanted

adverse effects

Electroencephalography

methods

Epilepsy

Temporal Lobe

diagnosis

physiopathology

surgery

Feasibility Studies

Female

Foramen Ovale

Functional Laterality

physiology

Humans

Male

Neurosurgical Procedures

Preoperative Care

methods

Temporal Lobe

physiopathology

surgery

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)