Complex Partial Seizures of Childhood Onset

Kotagal, Prakash; Rothner, A. David; Erenberg, Gerald; Cruse, Robert P.; Wyllie, Elaine

doi:10.1001/archneur.1987.00520230057014

Cited by 76 publications

(42 citation statements)

References 25 publications

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“…For example, the rate of spontaneous remission rate in children undergoing medical therapy for the treatment of temporal lobe epilepsy has been reported to be lower than 20%. [40,49,50] It has also been observed that, in a significant number of adult epileptic patients in whom subsequently surgery is performed, the initial seizures began in childhood. Furthermore, the risk of occurrence of psychiatric disorders in adult patients with childhood-onset epilepsy has been recently emphasized.…”

Section: Discussionmentioning

confidence: 99%

Surgery in epilepsy associated with focal lesions in childhood

Bourgeois¹,

Sainte‐Rose²,

Lellouch‐Tubiana³

et al. 1999

FOC

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Surgery in children with epilepsy is a new, evolving field. The important practical issues have been to define strategies for choosing the most suitable candidates, as well as the type and the optimum timing of epilepsy surgery. This study was undertaken to illustrate these points. To identify the factors that correlated with outcome, the authors analyzed a series of 200 children (aged 1–15 years, mean 8.7 years) who underwent surgery at the Hôpital Necker-Enfants Malades between 1981 and 1996. In 171 cases (85.5%) the epilepsy was medically refractory and was associated with focal cortical lesions. Surgery consisted of resection of the lesion without specifically attempting to identify and remove the "epileptogenic area." In the group of children whose seizures were medically refractory, the mean follow-up period was 5.8 years. According to Engel's classification, 71.3% of these children became seizure free (Ia), whereas 82% were in Class I. A multivariate statistical analysis revealed that among all the factors studied, the success of surgery in a patient in whom there was a good clinical-electroencephalogram-imaging correlation, depended on the patients' having undergone a minimally traumatic operation, a complete resection of the lesion, and a short preoperative seizure duration. After the surgical control of epilepsy, behavior disorders were more improved (31% of all patients) than cognitive function (25%). The patient age at onset, duration and frequency of seizures, intractability of the disease to therapy, and seizure characteristics, were correlated with cognitive, behavioral, and academic performance pre- and postoperatively. Multivariate statistical analysis revealed that cognitive dysfunction correlated highly with the duration of epilepsy prior to surgery, whereas behavioral disorders correlated more with seizure frequency. These data must be taken into account when selecting patients for surgical treatment and when deciding the timing of surgery. Early surgical intervention allows for optimum brain development.

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Section: Discussionmentioning

confidence: 99%

Surgery in epilepsy associated with focal lesions in childhood

Bourgeois¹,

Sainte‐Rose²,

Lellouch‐Tubiana³

et al. 1999

FOC

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“…As conseqüências psicossociais adversas da epilepsia de lobo temporal precoce são bem documentadas em crianças e adultos jovens (Lindsay et al, 1984;Pritchard et al, 1980;Taylor, 1983;Kodagal et al, 1987;Lindsay et al, 1984a). As crianças afetadas tendem a se isolar de seus colegas e, freqüentemente, são encaminhadas para escolas especiais.…”

Section: Revisão Da Literaturaunclassified

Depressão em crianças e adolescentes com epilepsia

Valente¹,

Thomé‐Souza²,

Kuczynski³

et al. 2004

Rev. psiquiatr. clín.

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A epilepsia, uma condição neurológica, apresenta uma freqüência elevada de transtornos psiquiátricos, em especial a depressão, que é a comorbidade psiquiátrica mais comum nesta população. Sabe-se que o transtorno depressivo pode comprometer muito mais a qualidade de vida de um paciente com epilepsia do que a gravidade da doença em si, daí a importância do seu diagnóstico. Entretanto, há poucos estudos sobre a prevalência e apresentação clínica da depressão nas crianças e adolescentes com epilepsia e nenhum sobre o seu tratamento. Este artigo tem como objetivo estudar as razões para o subdiagnóstico deste transtorno psiquiátrico e revisar as evidências para a ocorrência de possíveis mecanismos fisiopatológicos comuns. Para tal, revisamos estudos em modelos animais de epilepsia que demonstram uma diminuição de neurotransmissores implicados nos mecanismos patogênicos e tratamento da depressão Adicionalmente, estudamos as evidências oferecidas pelos estudos de neuroimagem e neuropsicológicos que corroboram a existência de uma disfunção das estruturas límbicas -frontais e temporais -nos pacientes com transtorno depressivo, que aparentemente também existe em pacientes com epilepsia. Portanto, este artigo de revisão dá evidência de que o conceito de relação causa-efeito para a ocorrência de depressão em pacientes com epilepsia precisa ser revisto.Palavras-chave: Epilepsia, depressão, crianças, subdiagnóstico. AbstractEpilepsy, a neurological disorder, presents a high frequency of psychiatric disorders, especially depression, which is the most common psychiatric comorbidity in these patients. It's known that depressive disorder may compromise these patient's life more than the severity of epilepsy, pointing to the importance of its diagnosis. However, there are few studies on the prevalence and clinical presentation of depression in childhood and adolescence and none on its treatment. This article aims to study the reasons for the subdiagnosis of this psychiatric disorder and review the evidences for the

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“…O índice de remissão para as epilepsias parciais sintomáticas ou criptogênicas varia de 10 a 62% 5,[32][33][34][35][36] . No grupo específico das epilepsias do lobo temporal, encontramos baixos índices de remissão 5,36 .…”

Section: Probabilidade De Remissãounclassified

Tratamento cirúrgico das epilepsias na criança

Costa¹

2002

J. Pediatr. (Rio J.)

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Objective: to review the literature on surgical treatment of epilepsy in children.Sources: this review article is based on critical analysis of literature concerning epilepsy surgery for children.Summary of the findings: in children and adolescents, developmental abnormalities and low-grade tumors predominate as causes and types of epilepsies. Extratemporal resections and hemispherectomies are common in pediatric series, and hippocampal sclerosis is rare. Seizure-free outcome is significantly less frequent after extratemporal or multilobar resection than after temporal resection in children than in adults, but the results are gratifying in both groups. Also, a global outcome, including parental satisfaction, developmental and social outcome, as well as activities of daily living (ADL), schooling, and behavioral changes should be considered. Pediatric epilepsy surgical series show that 60-100% of the patients have a good seizure outcome. Roughly 30 to 40% of patients improve some aspects of their behavior such as attention, aggressiveness, and hyperactivity and 16% of those start to attend school after surgery. Parents noted improvement of their social life in about 2/3 of children.Conclusions: surgery for epilepsy has now become a realistic therapeutic option for selected children and the field is likely to increase in the near future. Surgical therapy should not be considered unless there is a reasonably good chance of improving the patient's quality of life. ResumoObjetivo: realizar revisão bibliográfica sobre o tratamento cirúrgico das epilepsias na criança.Fontes dos dados: artigo de revisão baseado em análise crítica da literatura atual sobre cirurgia da epilepsia em crianças. Síntese dos dados:em crianças e adolescentes, as anormalidades de desenvolvimento e os tumores de baixo grau de malignidade predominam entre as etiologias possíveis. A esclerose hipocampal é rara nas séries pediátricas, em que predominam as resecções extratemporais e hemisferectomias. O controle total das crises é mais freqüente nas resecções temporais, e menos freqüente nas resecções extratemporais ou multilobares. Entretanto, os resultados são gratificantes em ambos os grupos. É importante também considerar o seguimento global do paciente, incluindo a satisfação dos pais, a melhora no desenvolvimento neuropsicomotor e social, as atividades da vida diária, as modificações comportamentais e no rendimento escolar. Nas séries pediátricas, 60-100% dos pacientes têm uma boa evolução pós-operatória. Aproximadamente 30 a 40% dos pacientes melhoram em algum aspecto do seu comportamento, tais como atenção, agressividade e hiperatividade, e 16% destes pacientes iniciam a atividade escolar após a cirurgia. Os pais notaram a melhora no comportamento social em aproximadamente 2/3 das crianças.Conclusões: a cirurgia da epilepsia em crianças tornou-se uma opção realística para casos selecionados, e tende a se expandir num futuro próximo. A terapêutica cirúrgica só deve ser indicada se houver uma boa oportunidade de melhorar a qualidade de ...

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Complex Partial Seizures of Childhood Onset

Cited by 76 publications

References 25 publications

Surgery in epilepsy associated with focal lesions in childhood

Surgery in epilepsy associated with focal lesions in childhood

Depressão em crianças e adolescentes com epilepsia

Tratamento cirúrgico das epilepsias na criança

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