{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T23:59:13Z","timestamp":1778975953194,"version":"3.51.4"},"reference-count":43,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Temporal lobe epilepsy (TLE) is the most common form of focal epilepsy, and about two\u2010thirds of patients with drug\u2010resistant TLE are surgical candidates. While many studies suggest better postoperative outcomes in children subjected to various types of surgery, there is limited data comparing adults and children who have undergone the same procedure over the same time period. This study aimed to compare long\u2010term seizure outcomes and identify prognostic factors in pediatric (defined as children less than or equal to 12\u2009years) and adult patients undergoing TLE surgery at a high\u2010volume epilepsy center in South India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study cohort comprised 684 consecutive patients (127 children, 557 adults) who underwent standard anterior temporal lobectomy. All underwent presurgical evaluation including video EEG, neuroimaging, and surgical decision was made in a multidisciplinary meet. Seizure freedom was defined as \u201cabsence of seizures or auras regardless of antiepileptic drug use,\u201d which was the primary outcome. The predictors determining outcome in both age groups were also analyzed. Logistic regression identified the predictors, and Kaplan\u2013Meier curves assessed long\u2010term seizure\u2010free survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Children had significantly shorter epilepsy duration pre\u2010surgery (8.38 versus 19.2\u2009years,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001) and significantly better seizure outcome (57.4% vs. 45.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.0165). Kaplan\u2013Meier analysis revealed longer median seizure\u2010free survival in children (120\u2009months) than adults (72\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      = .027). In adults, predictors of poor outcome included auditory aura, behavioral arrest, spike\u2013wave discharges during ictal onset, and bitemporal IEDs. Febrile seizures predicted a favorable outcome in children and adults. In children, neoplasia as a substrate was protective, while psychiatric co\u2010morbidity and multiple auras predicted seizure recurrence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Children benefit more from TLE surgery than adults, due to earlier intervention and shorter duration of seizures. The principle of \u201ctime is brain\u201d holds true in epilepsy; prolonged duration of uncontrolled seizures fosters network expansion, highlighting the need for \u201cearly surgical referral\u201d and \u201ccatching them young.\u201d<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epd2.70172","type":"journal-article","created":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T15:36:14Z","timestamp":1768059374000},"page":"435-447","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Drug\u2010resistant temporal lobe epilepsy: Seizure outcome in children versus adults"],"prefix":"10.1002","volume":"28","author":[{"given":"Gurumurthy","family":"Bharanidharan","sequence":"first","affiliation":[{"name":"R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology  Trivandrum India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ankith","family":"Bhasi","sequence":"additional","affiliation":[{"name":"R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology  Trivandrum India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathew","family":"Abraham","sequence":"additional","affiliation":[{"name":"R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology  Trivandrum India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George C.","family":"Vilanilam","sequence":"additional","affiliation":[{"name":"R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology  Trivandrum India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramshekhar N.","family":"Menon","sequence":"additional","affiliation":[{"name":"R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology  Trivandrum India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bejoy","family":"Thomas","sequence":"additional","affiliation":[{"name":"R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology  Trivandrum India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chandrasekharan","family":"Kesavadas","sequence":"additional","affiliation":[{"name":"R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology  Trivandrum India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vijayambika Sadasivam","family":"Nandini","sequence":"additional","affiliation":[{"name":"R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology  Trivandrum India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thareekh","family":"Basheer","sequence":"additional","affiliation":[{"name":"R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology  Trivandrum India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashalatha","family":"Radhakrishnan","sequence":"additional","affiliation":[{"name":"R. 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