Abstracts

Rationale: The symptomatology of auras and seizures reflects the activation of specific cortical areas by ictal discharges. Initial seizure semiology may provide valuable information about seizure onset zone, which is generally in close proximity to the epileptogenic zone, the area responsible for seizure generation. The frequency of auras is variable according to different studies, ranging from 20% to 81%. Patients with temporal lobe epilepsy (TLE) and mesial temporal sclerosis (MTS) may have either single or multiple auras. There is scarce data suggesting that multiple auras may be associated with nondominant hemisphere localized epilepsy and good surgical outcome. The aims of this study were: To study a homogeneous population of patients with drug-resistant TLE-MTS; To analyze the clinical data of these patients, regarding the presence and frequency of auras; To correlate the occurrence of multiple auras with laterality of MTS and surgery outcome. Methods: We reviewed data from all patients with TLE and MTS submitted to pre-surgical evaluation in Hospital S o Paulo, in the period from 2002 to 2010. Inclusion criteria: age > 14 years, electroclinical diagnosis of TLE and unilateral MTS on MRI. Exclusion criteria: left-handed patients; other lesions on MRI (except calcifications), which might be involved in the origin of seizures. Patients were classified in two groups: 1. without auras or single auras; and 2. multiple auras. Auras were defined according to the criteria recommended by the Commission of the International League Against Epilepsy. Patients with Engel s Class I outcome were considered as having good prognosis; the remaining patients were classified as poor prognosis. Results: One hundred and eighty-one patients (73 men) were included, with mean age of 38.7 years; 76 (42%) had right TLE and 105 left (58%). Seventy-eight (43.1%) patients had no/single auras (Group 1) and 103 (56.9%) had multiple auras (Group 2). A total of 141 patients were operated: 98 (69.5%) had good post-surgical prognosis and 43 (30.5%) poor. The presence of multiple auras did not show any correlation neither with the side of MTS (p=0.52) nor with the post-surgical prognosis (p=0.79).Conclusions: Multiple auras occur quite often in patients with TLE and MTS. However, the presence of multiple auras does not correlate with seizure focus laterality and does not predict the surgical outcome in operated patients.