title: Factors predicting the outcome following medical treatment of mesial temporal epilepsy with hippocampal sclerosis.
abstract: OBJECTIVE
  There is a lack of information from South America regarding factors that predict the clinical outcomes of patients treated medically for mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). This study was conducted to determine which of these factors are the most important.
  
  
  METHODS
  This study included 110 South American patients with MTLE-HS treated with antiepileptic drugs. The factors considered included age, gender, age of epilepsy onset, interval between the lesion and the first seizure, central nervous system infection, traumatic brain injury, perinatal asphyxia, febrile convulsion, history of status epilepticus, types of seizures, site of hippocampal sclerosis (HS), extrahippocampal pathology, and electroencephalogram (EEG) abnormalities. The patients were divided into two groups based on the response to treatment: Group I, seizure free for at least two years; and Group II, not seizure free.
  
  
  RESULTS
  On the multivariate analysis, the factors associated with a poor prognosis in terms of seizure frequency and control following treatment included the presence of an early onset of seizure, more than 10 seizures per month before treatment, and EEG abnormalities.
  
  
  CONCLUSIONS
  The recognition of risk factors, such as early onset of seizures, more than 10 seizures per month before treatment, and EEG abnormalities, could lead to the identification of risk groups among patients with MTLE-HS and refractory epilepsy, possibly designating these individuals as candidates for early epilepsy surgery.
authors.affiliation: Brain Research Centre, Institute of Neurosciences, Guayaquil Welfare Board, Guayaquil, Ecuador. Electronic address: javiersanchez503@yahoo.com.
authors.forename: Javier
authors.initials: J
authors.lastname: Sànchez
authors.affiliation: Brain Research Centre, Institute of Neurosciences, Guayaquil Welfare Board, Guayaquil, Ecuador.
authors.forename: Mirella
authors.initials: M
authors.lastname: Centanaro
authors.affiliation: Brain Research Centre, Institute of Neurosciences, Guayaquil Welfare Board, Guayaquil, Ecuador.
authors.forename: Juanita
authors.initials: J
authors.lastname: Solís
authors.affiliation: Brain Research Centre, Institute of Neurosciences, Guayaquil Welfare Board, Guayaquil, Ecuador.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Delgado
authors.affiliation: Brain Research Centre, Institute of Neurosciences, Guayaquil Welfare Board, Guayaquil, Ecuador.
authors.forename: Luis
authors.initials: L
authors.lastname: Yépez
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D002648:Child; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006624:Hippocampus / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012598:Sclerosis; D012640:Seizures / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D013020:South America / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Epilepsy surgery; Hippocampal sclerosis; Mesial temporal sclerosis; Outcome; Prognostic factors