OP57 – 2589: Temporal lobe epilepsy in children: Beyond hippocampal sclerosis

Abstract

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 paediatric surgical series and data on this patient group are scarce. Methods We studied 34 children and adolescents with drug-resistant TLE and MTS who had epilepsy surgery at our centre with regard to electroclinical characteristics, MRI features and histopathology. Special focus was set on 15 children in whom histopathology was consistent with Focal Cortical Dysplasia (FCD) Type IIIa. Results Clinical characteristics associated with this highly selective subset of patients were: the presence of febrile seizures during infancy, a shorter duration of active epilepsy, a lower age at epilepsy surgery, extended EEG changes as well as excellent outcomes after anterior temporo-polar resection. However, we were unable to detect any significant association with either specific features on neuroimaging or neuropathological subtyping of the hippocampal sclerosis. Conclusion Data on HS in children with temporal lobe epilepsy is scarce and available data sets limitied. In the light of this perspective we present the first detailed description and comprehensive data analysis of children with the novel entity of FCD Type IIIa.