Prognostic factors in patients with mesial temporal lobe epilepsy.
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.
Pittau
Francesca
F
Epilepsy Center for Adults and Children, Department of Neurological Sciences, University of Bologna, Bologna, Italy.
Bisulli
Francesca
F
Mai
Roberto
R
Fares
Jean Elia
JE
Vignatelli
Luca
L
Labate
Angelo
A
Naldi
Ilaria
I
Avoni
Patrizia
P
Parmeggiani
Antonia
A
Santucci
Margherita
M
Capannelli
Diana
D
Di Vito
Lidia
L
Gambardella
Antonio
A
Baruzzi
Agostino
A
Tinuper
Paolo
P
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