Patients with Mesial Temporal Sclerosis (MTS) but without Epilepsy
Abstract number :
1.204
Submission category :
Year :
2001
Submission ID :
3132
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
F. Matsuo, MD, Neurology, University of Utah, Salt Lake, UT; T. Constantino, MD, Neurology, University of Utah, Salt Lake, UT; K. Moore, MD, Radiology, University of Utah, Salt Lake, UT; L. Blair, APRN, Neurology, University of Utah, Salt Lake, UT
RATIONALE: High resolution MRI has been available for several years for further evaluation of patients with neurobehavior symptoms, when standard MRI was unrevealing, and improved demonstration of MTS correlating with the diagnosis of complex partial epilepsy (CPE). Incidental detection of MTS commonly results in further review of the clinical history and then CPE diagnosis. Our retrospective survey examined whether MRI demonstration of MTS always led to the didgnosis of CPE.
METHODS: Two groups of patients were identified: 1) those with interictal focal EEG transients over temporal regions and 2) those in whom the investigators[ssquote] clinical files included the MRI report of high resolution temporal lobe imaging. The medical records of patients thus identified were reviewed for the diagnosis.
RESULTS: A total of 438 patients with high resolution MRI of temporal lobes were identified and MTS was reported in 59. Only 4 patients were not diagnosed with CPE. Their principal neurobehavior symptoms were: nonepileptic attacks confirmed with video-EEG monitoring, recurrent affective symptoms following limbic encephalitis, an incapacitating affective disorder and paroxysmal neurobehavior symptoms triggered by the sound of siren from a fire engine, following severe burn.
CONCLUSIONS: Our four patients with MTS but without CPE suffered severe neurobehavior abnormality. Their symptoms were recurrent and/or paroxysmal, and they are likely susceptible to provoked epileptic seizures. Our survey is limited, because high resolution temporal lobe imaging was performed only after standard MRI was unrevealing and clinical suspicion remained. MRI screening in the normal population has not reported MTS.