Temporal lobe epilepsy surgery in children and adults: A multicenter study

Seizure and cognitive outcomes and their predictors were assessed retrospectively in 114 children and 397 adults undergoing temporal lobe epilepsy (TLE) surgery. • Significant differences in several presurgical, surgical, and postsurgical features were observed between children and adults. • Children were more likely to achieve sustained seizure freedom and drug withdrawal after TLE surgery. • Cognitive outcome was best predicted by preoperative performances in either age group. • Early referral should be prompted in order to improve surgical outcomes.

Objective: To assess seizure and cognitive outcomes and their predictors in children (<16 years at surgery) and adults undergoing temporal lobe epilepsy (TLE) surgery in eight Italian centers. Methods: This is a retrospective multicenter study. We performed a descriptive analysis and subsequently carried out multivariable mixed-effect models corrected for multiple comparisons. Results: We analyzed data from 511 patients (114 children) and observed significant differences in several clinical features between adults and children. The possibility of achieving Engel class IA outcome and discontinuing antiepileptic drugs (AEDs) at last follow-up (FU) was significantly higher in children (P =.006 and <.0001). However, percentages of children and adults in Engel class I at last FU (mean ± SD, 45.9 ± 17 months in children; 45.9 ± 20.6 months in adults) did not differ significantly. We identified different predictors of seizure outcome in children vs adults and at short- vs long-term FU. The on...