Abstracts

Rationale: To disclose anamnestic, clinical, familial, electrophysiological and neuroradiological factors correlated to prognosis in patients with mesial temporal lobe epilepsy (MTLE). Methods: 136 MTLE patients selected on the bases of semeiological and neurophysiological features, were studied for family history, clinical findings, neuropsychological, instrumental data (EEG, video-EEG, neuroimaging) and outcome. This population was divided into drug-resistant (DR: 108 pts, 79.4%) and non-drug-resistant (NDR: 28 pts, 20.6%) groups; all variables were studied in the two groups. Results: Comparing DR and NDR groups, the DR group had a higher frequency of: febrile seizure (FS) history (43.5% vs. 17.8%, p: 0.008), presence of MTS (64.8% vs. 32.1%, p: 0.0025), age at seizure onset before 3 years (23.1% vs. 3.6% p: 0.0160) and persistence of epileptiform interictal abnormalities after medical treatment (89.7% vs. 68%, p: 0.010). Familial cases were equally present in DR and NDR groups. Febrile seizures were more common in patients with MTS than in patients without (46.28% vs. 26,3%, p: 0.0199). Sixty-nine patients underwent surgery and 85.3% had a good outcome (Engel class I). Conclusions: MTLE is the most frequent form of partial epilepsy; it is a heterogeneous syndrome. Establishing the factors responsible for and associated with drug resistance is important for therapeutic purposes, as prompt diagnosis of drug resistance will lead to an early surgical approach. Febrile seizures, MTS, early age at seizure onset, and the persistence of epileptiform interictal abnormalities after medical treatment are negative prognostic factors. Furthermore, FS are related to MTS.