Outcome of surgical treatment in familial mesial temporal lobe epilepsy.
OBJECTIVE
To describe postoperative outcome in patients with familial mesial temporal lobe epilepsy (FMTLE).


METHODS
We studied FMTLE patients who underwent surgical treatment for refractory seizures. FMTLE was defined when at least two individuals in a family had a clinical EEG diagnosis of MTLE. Preoperative investigation included magnetic resonance imaging (MRI), interictal/ictal EEGs, and neuropsychological evaluation. We used Engel's classification for postoperative outcome.


RESULTS
To date, 20 FMTLE patients have been operated on, with 1.6 to 9.8 years of follow-up (mean, 5.5 years). Hippocampal atrophy (HA) and other signs of mesial temporal sclerosis (MTS) were present in 18 patients (15 unilateral). Seizures were recorded in 19 patients. Seventeen (85%) patients are in class I. Two patients had normal hippocampal volumes (HcV): one (5%) is in class II and the other (5%) in class IV (extratemporal seizures developed after surgery). One (5%) patient had bilateral HA and is in class III. Qualitative histopathology showed MTS with different degrees of severity.


CONCLUSIONS
Refractory FMTLE patients have good surgical outcome when unilateral or clearly asymmetric HA is identified. Preoperative investigation should be the same as that in patients with sporadic refractory MTLE.
Kobayashi
Eliane
E
Department of Neurology, University of Campinas, UNICAMP, Campinas, SP, Brazil.
D'Agostino
Maria Daniela
MD
Lopes-Cendes
Iscia
I
Andermann
Eva
E
Dubeau
François
F
Guerreiro
Carlos A M
CA
Schenka
André A
AA
Queiroz
Luciano S
LS
Olivier
André
A
Cendes
Fernando
F
Andermann
Frederick
F
D000328:Adult; D000679:Amygdala / Q000473:pathology / Q000601:surgery; D038481:Anterior Temporal Lobectomy; D001284:Atrophy; D004292:Dominance, Cerebral / Q000502:physiology; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006624:Hippocampus / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013702:Temporal Lobe / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome