title: The relevance of somatosensory auras in refractory temporal lobe epilepsies.
abstract: The purpose of this study is to look at the prevalence, characteristics, and prognostic value of somatosensory auras (SSAs) in patients who have undergone temporal lobe epilepsy (TLE) surgery to treat drug-resistant focal epilepsy. We retrospectively reviewed all patients with drug-resistant epilepsy who underwent TLE surgery at Cleveland Clinic between 2005 and 2010 (n = 333) to study the prevalence, characteristics, and prognostic implications of SSA in the context of TLE surgery. Analyses were performed using two seizure outcome definitions: complete seizure freedom and Engel classification. Of the 333 patients, 26 (7.8%) had SSA. Almost half (12 patients) had unilateral sensory symptoms, whereas the rest had bilateral symptoms. Tingling and numbness were the most frequently reported sensations. Compared to their non-SSA counterparts, patients with SSA had the same clinical and imaging characteristics, but had a higher rate of breakthrough seizures (p = 0.03), although most (54%) were still able to achieve Engel class of I (p = 0.02). Based on our results we would encourage detailed presurgical testing, which may include an invasive evaluation to analyze the extent of the epileptogenic zone in patients with SSA and suspected TLE.
authors.affiliation: Cleveland Clinic Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A.
authors.forename: Ghazala
authors.initials: G
authors.lastname: Perven
authors.affiliation: Cleveland Clinic Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A.
authors.forename: Ruta
authors.initials: R
authors.lastname: Yardi
authors.affiliation: Cleveland Clinic Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A.
authors.forename: Juan
authors.initials: J
authors.lastname: Bulacio
authors.affiliation: Cleveland Clinic Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A.
authors.forename: Imad
authors.initials: I
authors.lastname: Najm
authors.affiliation: Cleveland Clinic Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A.
authors.forename: William
authors.initials: W
authors.lastname: Bingaman
authors.affiliation: Cleveland Clinic Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A.
authors.forename: Jorge
authors.initials: J
authors.lastname: Gonzalez-Martinez
authors.affiliation: Cleveland Clinic Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A.
authors.forename: Lara
authors.initials: L
authors.lastname: Jehi
mesh_terms: D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D013003:Somatosensory Cortex / Q000473:pathology*; D014741:Video Recording
keywords: Refractory temporal lobe epilepsy; Somatosensory aura; Surgical outcome