Abstracts

RATIONALE: Our parallel study about the epilepsy after CNS infection revealed there was no substantial difference of clinical profiles except for the febrile convulsion, which suggested CNS infection itself might work as a potential cause of MTS. We tried to investigate the underlying pathogenesis of CNS infection as a potential cause of MTS by analysis of the clinical profile between the tuberculous meningitis (TBM) and encephalitis/other meningitis. METHODS: 38 epilepsy patients were enrolled with evidence of post CNS infection seizure by thorough review of past medical history. All the patients had the mesial temporal sclerosis (MTS) in MRI which were taken with the T1- and T2 weighted oblique coronal and spin echo sequences. 11 cases were grouped as TBM and remaining 27 cases as encephalitis group. Clincal profiles such as epidemilogic aspects, antecedents, seizure profiles, and prognosis were compared detaily between these two groups. The prognosis was defined to be poor if the reduction of seizure frequency was less than 50 %. RESULTS: Male patients were affected much more frequently(m:f=18:9) in encephalitis group. 9 cases (81.8 %)among TBM group showed additional lesion such as calcification and focal and/or diffuse cortical atrophy was associated with MTS in 11 cases (70.4 %) and patients in TBM group revealed grave prognosis (72.7 %) compared to encephalitis group (57.7 %). All the other semiological characteristics were not significantly different between two groups. CONCLUSIONS: The clinical profiles in these two groups were not significantly different except the aura and automatism, which were not actually related to the severity of the seizure. Poor prognosis in TBM group might be related to higher preponderance of the additional lesion other than MTS shown in MRI. We thought these findings suggested that infection related to underlying pathologic process might be associated with the formation of MTS rather than specific pathogen or high spiking fever in encephalitis as usual.