title: Coexistence of idiopathic generalized epilepsy among surgically treated patients with drug-resistant temporal lobe epilepsy.
abstract: BACKGROUND
  Failure to identify the association antiepileptic drug (AED)-resistant temporal lobe epilepsy (TLE) with idiopathic generalized epilepsy (IGE) can interfere with decision for anterior temporal lobectomy (ATL) and prediction of post-ATL seizure outcome.
  
  
  METHODS
  Out of the 664 consecutive patients who underwent ATL between March 1995 and December 2007, 12 (1.8%) had coexisting IGE. The decision for ATL was made after a thorough discussion in the multidisciplinary patient management conference based upon the concordance between the clinical, electroencephalographic and magnetic resonance imaging data. All of them underwent epilepsy surgery for AED-resistant TLE.
  
  
  RESULTS
  In seven of the 12 patients, IGE was not identified until post-ATL. During a median follow-up period of 8.5 years, 8 of our 12 patients were seizure-free; the remaining 4 patients only had infrequent myoclonus. In two them, AEDs were discontinued; others were on montherapy for IGE.
  
  
  CONCLUSIONS
  Our study highlights the rare association of IGE with TLE, the most common AED-resistant focal epilepsy syndrome. As the seizure outcome following ATL is similar in AED-resistant TLE patients with and without IGE, their co-existence is not a contraindication for ATL. Future studies should explore the molecular genetic basis of the rare association between these two epilepsy syndromes.
authors.affiliation: R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Sree Chitra Tirunal Institute for MedicalSciences and Technology, Trivandrum, Kerala, India. drashalatha@sctimst.ac.in
authors.forename: Ashalatha
authors.initials: A
authors.lastname: Radhakrishnan
authors.forename: Ramshekar N
authors.initials: RN
authors.lastname: Menon
authors.forename: Kurupath
authors.initials: K
authors.lastname: Radhakrishnan
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D004569:Electroencephalography / Q000379:methods; D004829:Epilepsy, Generalized / Q000150:complications* / Q000188:drug therapy; D004833:Epilepsy, Temporal Lobe / Q000150:complications* / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000927:Anticonvulsants