Prospective Follow-Up of Newly Diagnosed Patients with Adult Onset Partial Epilepsy; qMRI and Cognitive Study
Abstract number :
1.209
Submission category :
Year :
2001
Submission ID :
426
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
T. Salmenperä, MD, Department of Neurology, University of Kuopio, Kuopio, Finland; M. äikiä, MA, Department of Neurology, Kuopio University Hospital, Kuopio, Finland; A. Pitkänen, MD, PhD, A.I.Virtanen Institute, Kuopio, Finland; R. Kälviäinen, MD, PhD, D
RATIONALE: Quantitative magnetic resonance imaging (qMRI) and neuropsychological evaluation provide objective means of assessing the degree of hippocampal pathology in epilepsy. There are, however, few prospective studies of the possible functional or prognostic consequences of early damage in newly diagnosed epilepsy patients.
METHODS: Newly diagnosed adult patients (n=120; mean age 32 years, range 15-70 years; mean IQ 107, range 62-142) with partial, previously untreated epileptic seizures were investigated in a prospective MRI-study using 1.5 T Magnetom. The Cavalieri method was used in combination with point counting to provide unbiased estimates of the volume of the left and right hippocampus. Additionally the patients were analyzed with comprehensive neuropsychological battery. The follow-up MRI scans and neuropsychological tests were performed together with clinical evaluation at 1 year, 2 and 5 years after the diagnosis.
RESULTS: The mean left and right hippocampal volumes in a baseline analysis of 120 newly diagnosed patients with partial epilepsy did not differ significantly compared with controls. As a group no significant progressive damage was observed during one-year follow-up. Individual data of longer follow-up of 2 to 5 years is under analysis. No correlation was found between the volume of the left hippocampus and the verbal memory tests at baseline. Correspondingly, the volume of the right hippocampus did not correlate with the visual memory tests at baseline. Poorer seizure-outcome after one-year follow-up was determined by presence of memory impairment, hippocampal damage, spike focus in EEG, partial complex or mixed seizure type and younger age at the time of diagnosis.
CONCLUSIONS: As refractory epilepsy should be identified as early as possible in order to improve the prognosis, our results emphasize the importance of the high-resolution MRI and neuropsychological testing both in terms of diagnostic work-up and with respect to prognostic evaluation.