title: Variability of presentation in medial temporal lobe epilepsy: a study of 30 operated cases.
abstract: BACKGROUND
  To evaluate the homogeneity of patients operated on for MTLE.
  
  
  METHODS
  30 consecutive patients prospectively investigated with clinical, EEG, neuropsychology, MRI, FDG-PET criteria and eventually intracranial EEG, who underwent antero-medial temporal resection (follow-up: 24 months).
  
  
  RESULTS
  Clear and well-lateralised MTLE was non-invasively ascertained in 22 patients (73%). Eight patients (27%) had a less pure presentation due to divergent scalp EEG features (bitemporal, widespread or extratemporal), unusual auras or absence of MRI-based hippocampal sclerosis or FDG-PET hypometabolism. They were explored by invasive monitoring which confirmed medial temporal origin of seizures. Outcome was excellent in 95% of the pure cases (Engel's class I) and less favorable in the more difficult ones (65% of class I).
  
  
  CONCLUSIONS
  MTLE criteria, including the strong contribution of brain imaging, permit to select accurately a large percentage of patients. However a consistant number of patients present a less pure presentation suggesting more complex epileptogenic networks.
authors.affiliation: Service de Neurophysiologie, Hôpital de la Pitié-Salpêtrière, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Adam
authors.forename: S
authors.initials: S
authors.lastname: Clemenceau
authors.forename: F
authors.initials: F
authors.lastname: Semah
authors.forename: D
authors.initials: D
authors.lastname: Hasboun
authors.forename: S
authors.initials: S
authors.lastname: Samson
authors.forename: N
authors.initials: N
authors.lastname: Aboujaoude
authors.forename: Y
authors.initials: Y
authors.lastname: Samson
authors.forename: M
authors.initials: M
authors.lastname: Baulac
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000473:pathology; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology* / Q000523:psychology / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011569:Psychiatric Status Rating Scales