Abstracts

Rationale: Temporal lobe epilepsy (TLE) associated with hippocampal sclerosis (HS), also known as mesial temporal sclerosis (MST), is the most common type of drug-resistant epilepsy referred for epilepsy surgery; it often responds favorably to surgery . However, epilepsy surgery is not being performed in many developing countries. There is a scarcity of information regarding the epidemiology of TLE in the developing countries, and in particular from the Middle- East , especially from Qatar.To learn more about the epidemiology of drug-resistant HS-TLE in Qatar, we designed this study as a review of the literature on the epidemiology of epilepsy and TLE in the region, and then, we estimated the prevalence and incidence of drug-resistant HS-TLE in Qatar. To the best of our knowledge, direct data on this important topic is lacking in the literature. With the ongoing plans to develop surgical therapies for epilepsy in Qatar in the near future, this data may provide valuable information for the authorities, health care professionals, researchers, industry, and agencies involved in the management of people with this epilepsy syndrome in Qatar and even other regional countries. Methods: We searched the electronic database PubMed from January 1947 to April 11, 2018 using the following search terms in the title: “epilepsy” OR “temporal lobe” OR “hippocampal sclerosis” AND “epidemiology” OR “prevalence” OR “incidence”. Relevant original studies were included. We also reviewed several systematic reviews, meta-analyses, and their references. Studies that investigated special populations, studies that reported lifetime prevalence of epilepsy, and studies that investigated special situations were not included .We extrapolated from the published data to estimate the prevalence and incidence of drug-resistant HS-TLE in Qatar Results: We concluded that the estimated Qatar prevalence of drug-resistant HS-TLE is between 0.3 and 0.6 cases per 1,000 people. The reviewed studies also helped us provide a reasonable estimate of the Qatar incidence of drug-resistant HS-TLE from 2.3 to 4.3 cases per 100,000 people per year. This means that currently, and with a Qatar's population of 2,682,556 people, more than 800 patients in Qatar suffer from drug-resistant HS-TLE. The scenario becomes more complicated by the estimate that each year more than 60 patients are being added to this pool. Conclusions: Epidemiological studies on drug resistant HS-TLE are needed. However, several observational studies allow adequate estimates of the range for the incidence and prevalence of this condition. Given the morbidity and mortality associated with uncontrolled seizures, this large and growing patient population is a matter of concern in Qatar.This highlights the urgent need for establishing an active epilepsy surgery program in Qatar and other similar countries. Funding: None