Long-term seizure and social outcomes following temporal lobe surgery for intractable epilepsy during childhood

Mony Benifla, James T. Rutka, Hiroshi Otsubo, Maria Lamberti-Pasculli, Irene Elliott, Eric Sell, Rajesh RamachandranNair, Ayako Ochi, Shelly K. Weiss, O. Carter Snead, Elizabeth J. Donner

Research output: Contribution to journalArticlepeer-review

55 Scopus citations


Purpose: Studies of adults who underwent temporal lobectomy for intractable temporal lobe epilepsy (TLE) demonstrated declining seizure free rates over time. Using seizure and social parameters, we followed patients who had temporal lobe surgery (TLS) in childhood to determine long-term outcomes. Methods: We identified 42 patients who underwent TLS for medically intractable epilepsy during childhood. Follow-up data were collected from 10 to 20 years after surgery (median, 12 years). We studied histopathology, seizure outcome, employment, school enrolment, and driver's licensing. Patients or parents graded their satisfaction with TLS. Results: Number of Engel class I patients was 34 (81%) after 6 months; 32 (76%) after 1 year; 30 (71%) after 5 years; and 28 (67%) at last ≥10 years follow-up. Nineteen (79%) of 24 children with tumors or cavernous angioma achieved class I outcomes in contrast to 9 (50%) of 18 children with other pathologies (p < 0.05). Ten (56%) of 18 recurrent seizure patients experienced seizures within the first year; 4 required reoperation for seizure freedom. More seizure free patients (24, 86%) than residual seizure patients (8, 57%) were employed or in school (p = 0.05). Twelve (63%) of 19 eligible patients obtained driver's licenses. Twenty-three (82%) of 28 seizure free patients discontinued anticonvulsants. Surgery grading averaged "satisfied." Class I patients reported greater satisfaction than class III/IV patients (p < 0.001). Conclusion: Two-thirds of children who underwent TLS achieved seizure freedom at ≥10 year follow-up. Children with tumors or cavernous angiomas achieved better long-term outcomes than those with other histopathologies. Long-term seizure free patients were most often satisfied with surgery and employed or in school.

Original languageEnglish
Pages (from-to)133-138
Number of pages6
JournalEpilepsy Research
Issue number2-3
StatePublished - 1 Dec 2008
Externally publishedYes


  • Children
  • Intractable temporal lobe epilepsy
  • Long-term
  • Psychosocial outcome
  • Seizure outcome
  • Temporal lobe surgery


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