ANTERIOR TEMPORAL LOBE ABNORMALITIES ASSOCIATED TO HIPPOCAMPAL SCLEROSIS IN TEMPORAL LOBE EPILEPSY PATIENTS
Abstract number :
2.067
Submission category :
Year :
2002
Submission ID :
1032
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Damian E. Consalvo, Silvia A. Oddo, Walter H. Silva, Pablo A. Salgado, Patricia Solis, Brenda Giagante, Patricia Saidon, Eduardo Seoane, Silvia S. Kochen. Epilepsy Center, Neurology Division, Ramos Mejia Hospital, Buenos Aires, Argentina; FEMIEN Foundatio
RATIONALE: Anterior temporal lobe abnormalities (TLA) associated to hippocampal sclerosis (HS) are more frequently recognized as a result of the use of high resolution magnetic resonance imaging (MRI) in temporal lobe epilepsy patients.
The aim of the study was to compare patients with HS and patients with HS plus TLA (HS Plus) to find out if they belong into two different groups.
At the end of this activity, the participants should be able to identify this kind of abnormalities on the MRI and their clinical differences.
METHODS: We selected, retrospectively, patients with temporal lobe epilepsy diagnosed on the basis of clinical and EEG data and HS on their MRI.
They were divided in two groups: patients with only HS (Group 1) and patients with HS Plus (Group 2).
We analyzed side affected, average age (AA), time of evolution (TE), age at onset (AO) of the epilepsy, febrile convulsions (FC), status epilepticus (SE), family history (FH) of epilepsy, monthly seizure frequency (SF), interictal epileptiform abnormalities on the EEG (IEA), and their coincidence with the side affected on the MRI (CSA), and response to treatment.
RESULTS: We included 83 patients.
Group 1 (n=62), 26 males (41.9%). Left side affected in 23 cases (37.1%), right in 30 (48.4%) and bilateral in 9 (14.5%). AA 38 [plusminus] 10 years, TE 25 [plusminus] 12.2, AO 12.7 [plusminus] 10.3, 14 (22.5%) with FC, 4 (6.4%) with SE, 17 (27.4%) with FH, SF 7 [plusminus] 9.5 (range 0-60). EEG showed IEA in 43 cases (69.3%) and CSA in 24 cases (38.7%). Refractory patients 45 (72.5%), 18 were operated and 14 (77.7%) are in class I of Engel.
Group 2 (n=21), 12 males (57.1%). Left side affected in 17 cases (80.9%), right in 4 (19.1%). AA 35.6 [plusminus] 13.6 years, TE 27 [plusminus] 11.7 years, AO 8 [plusminus] 7.2 years, 6 (28.5%) with FC, 6 (28.5%) with SE, 3 (14.3%) with FH, SF 5 [plusminus] 6.5 (range 0-30). EEG showed IEA in 18 cases (85.7%) and CSA in 16 cases (76.2%). Refractory patients 16 (76.2%), 4 patients were operated and all of them (100%) are in class I of Engel.
There were statistically significant differences in the side affected, more frequent on the left in-group 2 (p[lt]0.01), AO, lower in-group 2 (p=0.05), SE more frequent in-group 2 (p=0.01) and CSA, higher in-group 2 (p[lt]0.01).
CONCLUSIONS: Our results suggest that HS Plus patients may be different from cases that show only HS.