title: Type of preoperative aura may predict postsurgical outcome in patients with temporal lobe epilepsy and mesial temporal sclerosis.
abstract: OBJECTIVE
  As the initial symptoms of epileptic seizures, many types of auras have significant localizing or lateralizing value. In this study, we hypothesized that the type of aura may predict postsurgical outcome in patients with medically refractory temporal lobe epilepsy (TLE) and mesial temporal sclerosis (MTS).
  
  
  METHODS
  In this retrospective study, all patients with a clinical diagnosis of medically refractory TLE due to unilateral mesial temporal sclerosis who underwent epilepsy surgery at the Jefferson Comprehensive Epilepsy Center were recruited. Patients were prospectively registered in a database from 1986 through 2014. Postsurgical outcome was classified into two groups: seizure freedom or relapse. Outcome was compared between seven groups of patients according to their preoperative auras.
  
  
  RESULTS
  Two hundred thirty-seven patients were studied. The chance of becoming free of seizures after surgery in patients with abdominal aura was 65.1%, while in other patients, this was 43.3% (P=0.01). In two-by-two comparisons, no other significant differences were observed.
  
  
  CONCLUSIONS
  Patients with medically refractory TLE-MTS who reported abdominal auras preceding their seizures fared better postoperatively with regard to seizure control compared with those who did not report auras, which may indicate bitemporal dysfunction, and to patients with other auras, which may indicate a widespread epileptogenic zone in the latter group of patients.
authors.affiliation: Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: aliasadipooya@yahoo.com.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Asadi-Pooya
authors.affiliation: Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: maromi.nei@jefferson.edu.
authors.forename: Maromi
authors.initials: M
authors.lastname: Nei
authors.affiliation: Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: ashwini.sharan@jefferson.edu.
authors.forename: Ashwini
authors.initials: A
authors.lastname: Sharan
authors.affiliation: Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: michael.sperling@jefferson.edu.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Sperling
mesh_terms: D000328:Adult; D000069279:Drug Resistant Epilepsy / Q000175:diagnosis* / Q000601:surgery*; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D012598:Sclerosis / Q000175:diagnosis / Q000601:surgery; D013702:Temporal Lobe / Q000473:pathology*
keywords: Aura; Outcome; Surgery; Temporal lobe epilepsy