Is the Complex Partial Seizure without 2[ssquote]GTC a Subgroup of MTLE? Comparison of Clinical Profiles between Complex Partial Seizure with and without 2[ssquote] GTC in MTLE.
Abstract number :
2.103
Submission category :
Year :
2001
Submission ID :
257
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
S. Park, MD, PhD, Neurology, Yonsei University, Seoul, Republic of Korea; J. Cho, MD, Neurology, Yonsei University, Seoul, Republic of Korea; H. Shin, MD, Neurology, Yonsei University, Seoul, Republic of Korea
RATIONALE: Some surgical candidate with MTS did not evolve to 2[ssquote]generalized seizure even completely withdrawal of AEDs during ictal EEG monitoring for epilepsy surgery. That means there is a possibility of clinically different subgroup with unique clinical parameter especially in MTLE group. So, we tried to reveal that the clinical profiles of MTLE showing only complex partial (CP) seizure without 2[ssquote]GTC were different from those with 2[ssquote] GTC.
METHODS: 171 who had been actively followed up from outpatient clinic were recruited. All patients had unilateral mesial temporal sclerosis without any dual lesion in MRI. Cases with temporal lobe tumor and trauma/ post CVA related cerebromalatic lesion were excluded. The presence of 2[ssquote]GTC were focused on from the initial detailed history taking and during OPD follow up (mean; 6.2 years). The patients divided into two groups depending on the presence of 2[ssquote]GTC strictly; CP seizure only group and 2[ssquote] GTC group. The prognosis decided to be good if the patient was seizure free or aura only after at least 2 years of antiepileptic drug treatment.
RESULTS: 41 patients(24.0 %) among 171 patients belonged to CP only group. The laterality of MTS, mean of age onset, history of febrile convulsion, the nature and prevalence of aura and automatism, and seizure frequency were not statistically different from between two groups (p[lt]0.05). Overall prognosis between two groups was also not signifcantly different. But female preponderance and history of CNS infection (14.6 vs. 6.2 %) were higher in CP only group than 2[ssquote]GTC group. The history of head trauma and nocturnal preponderance were significant higher in 2[ssquote] GTC group (0 % vs.10 % and 4.9 % vs. 17.7 %, respectively).
CONCLUSIONS: There was no statistically significant differences between two groups in clinical profiles such as seizure frequency, aura, and automatism, including overall prognosis even though there were some preponderance in sex ratio and remote symptomatic etiologies such as head trauma and CNS infection. This study showed the CP only without 2[ssquote]GTC in MTLE was one clinical pattern on the line of the evolutional spectrum of a full brown MTLE without remarkably discernable clinical parameters.