Abstracts

RATIONALE: Mesial temporal sclerosis (MTS) is the most important pathological landmark in mesial temporal epilepsy (MTLE). However, there are no defined preceding events leading to MTS except for the histroy of febrile convulsion. In practice, we have sometimes met intractable epilepsy patients with MTS and only a history of CNS infection. We investigated the CNS infection as a potential cause of MTS by reviewing the clinical data. METHODS: We reviewed the clinical data of epilepsy patients who had visited Yonsei University Severance Hospital for last 10 years and divided into two groups: 1) CNS infection (CNS) group: patients with MTS on MRI and history of habitual seizures after CNS infection, 2) Conventional unilateral MTLE (COnventional) group. We compared the clinical data including sex, age of onset, laterality of MTS, semiology, frequency of seizure, whether or not the presence of secondarily generalized seizures, and prognosis. We decided the prognosis to be poor if the reduction of seizure frequency was less than half. RESULTS: Total enrolled population were 178: 38 in CNS group and 140 in Conventional group. In CNS group, 20 patients had additional lesions other than MTS, including diffuse and/or focal cortical atrophy. Purely unilateral MTS was seen in 12 patients and bilateral in 6 patients. CNS group also revealed male preponderance, laterality in left side, more frequent nonlimbic aura, and poorer prognosis compared to Conventional group. In Conventional group, a history of febrile convulsion and limbic aura were more frequently associated. CONCLUSIONS: Our data revealed some minor differences in seizure profiles between two groups which could be explained by accompanied lesions in MRI except for febrile convulsion. We concluded that there was no substantial difference between these two groups and CNS infection itself might work as a potential cause of MTS.