Phenotypic characteristics of temporal lobe epilepsy: the impact of hippocampal sclerosis.
OBJECTIVE
Whether mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) is a condition with a unique biological background that can be delineated from other TLE, is unresolved. Here we performed a comparative analysis of two TLE patient cohorts - one cohort with HS and one without HS - in order to identify phenotypic characteristics specifically associated with MTLE-HS.


METHODS
Epidemiological data and clinical and diagnostic features were compared between patients with MTLE-HS and TLE patients without HS. When appropriate, data were compared with healthy controls.


RESULTS
Fifty-six (26%) patients were diagnosed with MTLE-HS and 162 (74%) with other TLE. Age at epilepsy onset was lower in patients with MTLE-HS (P = 0.003) than in TLE patients without HS. Incidence of simple partial seizures was higher in the MTLE-HS group (P = 0.006), as were complex partial seizures (P = 0.001), ictal psychiatric symptoms (P = 0.015), and autonomic symptoms (P < 0.001). Interictal psychiatric symptoms, including depression, were less frequent in MTLE-HS (P = 0.043). MTLE-HS patients had a higher incidence of childhood febrile seizures (FS; P = 0.043) than TLE patients without HS. In contrast, the former group had the lower frequency of first-grade family members with childhood FS (P = 0.019).


CONCLUSIONS
We identified phenotypic characteristics that distinguish MTLE-HS from other types of TLE. These characteristics will be important in diagnostics, treatment, and determination of prognosis, and provide a basis for future phenotype-genotype studies.
Heuser
K
K
Department of Neurology, Division for Clinical Neuroscience, Rikshospitalet University Hospital, Oslo, Norway. kjell.heuser@rikshospitalet.no
Taubøll
E
E
Nagelhus
E A
EA
Cvancarova
M
M
Petter Ottersen
O
O
Gjerstad
L
L
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D001007:Anxiety / Q000209:etiology; D015331:Cohort Studies; D003863:Depression / Q000209:etiology; D003937:Diagnosis, Differential; D004833:Epilepsy, Temporal Lobe / Q000235:genetics* / Q000473:pathology*; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D012598:Sclerosis