Long-term Outcome of Treatment in Naïve Patients with Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis
Abstract number :
2.445
Submission category :
4. Clinical Epilepsy / 4D. Prognosis
Year :
2022
Submission ID :
2232897
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:28 AM
Authors :
Joonho Kim, MD – Yonsei University College of Medicine; Kyoung heo, MD, PhD – Professor, Department of Neurology, Yonsei University College of Medicine
This is a Late Breaking abstract
Rationale: This study aimed to report our experience of the long-term outcomes of treatment in naïve patients with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS), in order to evaluate the clinical course and long-term prognosis.
Methods: Of the 4,027 consecutive patients who visited the Yonsei Epilepsy Clinic by a physician from April 2000 to September 2022, 84 untreated MTLE-HS patients were included. Demographic and clinical variables were collected. Treatment outcomes following medical treatment were assessed using the terms "seizure freedom (SF)" and "complete SF." SF was defined as seizures absent or non-disabling auras only while complete SF was defined as both seizures and non-disabling auras absent. Postoperative seizure outcomes were classified using the International League Against Epilepsy (ILAE) scale.
Results: The median duration of follow-up (FU) was 121.5 months (range, 31-254 months). Except for a patient whose duration of medical treatment was less than a year, 31 (37.3%) out of 83 patients achieved 1 year SF and remained in remission until the end of FU. Thirty-eight (45.8%) showed fluctuations in seizure control: 22 (26.5%) achieved 1 year SF more than once, relapsed, and eventually attained SF more than a year at the last FU and 16 (19.3%) achieved 1 year SF more than once and had a recurrence of seizures during the last 1 year FU period. The remaining 14 (16.9%) patients never achieved SF for any 12 months period. On the other hand, 18 (21.7%) patients achieved 1 year complete SF and remained in complete remission until the end of FU. Sixteen (19.3%) achieved 1 year complete SF more than once, relapsed, and eventually attained complete SF more than a year at the last FU. Twenty-six (31.3%) achieved 1 year complete SF more than once and had a recurrence of seizures during the last 1 year FU period. Twenty-three (27.7%) never achieved complete SF for any 12 months period. Eleven patients (14.3%) underwent anterior temporal lobectomy. All 11 patients had ILAE Class 3 outcomes or better at the last FU.
Conclusions: The findings of this study provide a comprehensive description of treatment outcomes in naive MTLE-HS patients.
Funding: None
Clinical Epilepsy