Abstracts

Rationale: There is a notion that a large percentage of patients with Temporal Lobe Epilepsy (TLE) are surgical candidates. The rate of patients with TLE that are well controlled with anti-epileptic drugs (AEDs) are not commonly reported. Methods: We analyzed the seizure outcome of a large cohort of adult patients with TLE from the Epilepsy Program in the province of Saskatchewan, Canada from 2007 to 2013. Etiology and epilepsy syndromes were classified according the ILAE criteria. Mean follow was 40 months (range, 6-84 months) Results: A total of 172 patients with TLE were identified. The mean age was 45.3 + 14.5 and 51% were males. At the end of the follow-up, 47 patients (27%) were seizure free while receiving medication, 73 (42%) underwent epilepsy surgery (ES), 11 (6%) are waiting for ES, 17 (10%) are waiting for investigations for ES, 10 (6%) were investigated and were not candidates for ES, 8 (5%) refuse ES and 6 (3%) were death. Patients with TLE who are well controlled with medications were older than the rest of the group (51.3 + 16 vs. 43+ 13; p: 0.001), also were older at diagnosis of epilepsy (36.6 + 21.6 vs. 18.67 + 15; p: <0.001); had a better response to the first AED (OR= 2.44; CI, 1.5-3.9); with less frequent seizures per month (0.23 + 0.84 vs. 3.7 + 7.3; p: 0.001), finally they have had les AEDs trials (2.3 + 1.4 vs. 4.86 + 1.9; p: < 0.001). Conclusions: This study supports the notion that a fair percentage of patients (27%) with TLE are seizure free with medications. Patients with well controlled TLE using AEDs were older than surgical cases. This study also support that TLE is highly intractable and 67% of patients will eventually require epilepsy surgery.