title: Very Long-Term Outcome of Non-Surgically Treated Patients with Temporal Lobe Epilepsy with Hippocampal Sclerosis: A Retrospective Study.
abstract: OBJECTIVE
  Surgical intervention can result in complete seizure remission rates of up to 80% in patients with temporal lobe epilepsy with hippocampal sclerosis (TLE-HS). However, certain patients cannot be treated surgically for various reasons. We analyzed the very long-term clinical outcomes of patients with TLE-HS who could not be treated surgically.
  
  
  METHODS
  Subjects were selected from among patients with TLE-HS who were actively followed up for >10 years and treated with medication without surgical treatment. Patient medical records were used to retrospectively study seizure frequency, various clinical factors, and social adjustment. Patients who were seizure-free or had only aura were classified into Group 1; the others were classified into Group 2. Clinical factors including both patient and disease-specific factors were compared between the two groups. Current social adjustment, including the education, work, and economic status of each patient, was also investigated.
  
  
  RESULTS
  Forty-one (41) subjects met the criteria for analysis, of which 12 (29%) were classified into Group 1. The average age of patients in Group 1 was higher than that of Group 2 (p = 0.0468). Group 2 included a significantly higher rate of patients who had more than one seizure per week at the onset (p = 0.0328), as well as a greater mean number of anti-epileptic drugs taken (p = 0.0024). Regarding social adjustment, Group 2 contained significantly fewer current jobholders than Group 1 (p = 0.0288).
  
  
  CONCLUSIONS
  After very long-term follow-up periods, 29% of patients with TLE-HS had a good outcome through treatment with anticonvulsant medications. Older patients tended to have fewer seizures, and seizure frequency at the onset was the only factor that predicted outcome.
authors.affiliation: Department of Psychiatry and Neurology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Tsugiko
authors.initials: T
authors.lastname: Kurita
authors.affiliation: Department of Psychiatry and Neurology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Sakurai
authors.affiliation: Department of Psychiatry and Neurology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Youji
authors.initials: Y
authors.lastname: Takeda
authors.affiliation: Department of Psychiatry and Neurology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Horinouchi
authors.affiliation: Department of Psychiatry and Neurology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kusumi
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use*; D004833:Epilepsy, Temporal Lobe / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012598:Sclerosis; D012640:Seizures / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants