title: Prognostic factors in patients with mesial temporal lobe epilepsy.
abstract: OBJECTIVE
  To disclose clinical, electrophysiologic, and neuroradiologic factors correlated to prognosis in patients with mesial temporal lobe epilepsy (MTLE).
  
  
  METHODS
  One hundred thirty-six MTLE patients were studied for family history, clinical characteristics, instrumental data [electroencephalography (EEG), video-EEG, neuroimaging], and outcome. The population was divided into drug-resistant (DR: 108 patients, 79.4%) and non-drug-resistant (NDR: 28 patients, 20.6%) groups; all variables were analyzed in the two groups.
  
  
  RESULTS
  The comparison between the two groups shows a relation between resistance to therapy and febrile seizures (FS) (DR 43.5% vs. NDR 17.8%, p = 0.008), mesial temporal sclerosis (MTS) (DR 64.8% vs. NDR 32.1%, p = 0.0025), early age at seizure onset (DR 23.1% vs. NDR 3.6% p = 0.0160), and epileptiform interictal abnormalities (DR 89.7% vs. NDR 68%, p = 0.010). FS were more frequent in patients with MTS than in patients without (46.28% vs. 26.3%, p = 0.0199). Sixty-nine patients underwent surgery and 85.3% of them had a good outcome.
  
  
  CONCLUSIONS
  MTLE is a heterogeneous syndrome. Establishing the factors responsible for and associated with drug resistance is important for therapeutic purposes, as prompt diagnosis of drug resistance must lead to early surgical management. This study shows that FS, MTS, early age at seizure onset, and epileptiform interictal abnormalities are negative prognostic factors and that FS are related to MTS.
authors.affiliation: Epilepsy Center for Adults and Children, Department of Neurological Sciences, University of Bologna, Bologna, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Pittau
authors.forename: Francesca
authors.initials: F
authors.lastname: Bisulli
authors.forename: Roberto
authors.initials: R
authors.lastname: Mai
authors.forename: Jean Elia
authors.initials: JE
authors.lastname: Fares
authors.forename: Luca
authors.initials: L
authors.lastname: Vignatelli
authors.forename: Angelo
authors.initials: A
authors.lastname: Labate
authors.forename: Ilaria
authors.initials: I
authors.lastname: Naldi
authors.forename: Patrizia
authors.initials: P
authors.lastname: Avoni
authors.forename: Antonia
authors.initials: A
authors.lastname: Parmeggiani
authors.forename: Margherita
authors.initials: M
authors.lastname: Santucci
authors.forename: Diana
authors.initials: D
authors.lastname: Capannelli
authors.forename: Lidia
authors.initials: L
authors.lastname: Di Vito
authors.forename: Antonio
authors.initials: A
authors.lastname: Gambardella
authors.forename: Agostino
authors.initials: A
authors.lastname: Baruzzi
authors.forename: Paolo
authors.initials: P
authors.lastname: Tinuper
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000235:genetics / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D055815:Young Adult