Abstracts

Rationale: After epilepsy surgery the median proportion of long-term seizure-free patients is 66% with temporal lobe resections, 46% with occipital and parietal resections, and 27% with frontal lobe resections (Téllez-Tenteno JF et al., 2005). Clinical experience suggested that patients suffering not only from focal epilepsy but also from type 1 diabetes mellitus have a less favourable seizure outcome after epilepsy surgery. Methods: We analyzed the postoperative seizure outcome of 6 patients who suffered from focal epilepsy and type 1 diabetes mellitus. Results: Age at seizure onset was between 8 and 17 years (mean 13 years). Epilepsy surgery was performed after an epilepsy duration between 3 and 32 years (mean 15 years). Five patients suffered from temporal lobe epilepsy. Three were right-sided, two with limbic encephalitis, one with mesial temporal sclerosis and two had a brain derived tumor in the left temporal lobe. One patient had left-sided frontal lobe epilepsy due to a perinatal vascular-ischemic lesion. In a follow-up period of at least 6 months, none became seizure free after epilepsy surgery (Engel 1B to 4B). Conclusions: This first observation suggests that diabetes mellitus type I could represent a negative predictor for seizure outcome after epilepsy surgery. Interesting in this context is the fact that drug-resistant epilepsy is associated with a high titer of anti-GAD antibodies (Giometto B et al., 1998), which are widely recognized as a marker of type 1 diabetes (Atkinson MA et al, 1994 and Seissler J et al., 1993).