Abstracts

Rationale: The prototype of a surgically remediable syndrome is mesial temporal lobe epilepsy-hippocampal sclerosis (MTLE-HS) (Engel, 1999). In this context, epileptologists around the world have avoided the classical concept of pharmacoresistance and once failure of first line antiepileptic drugs(AEDs) is demonstrated, these patients are referred for epilepsy surgery. However, it is reasonable to question if these concepts are disseminated or restricted to a group of neurologists in tertiary care centers, especially in developing countries. The aim of this study was: (i) to determine the duration of epilepsy until referral for epilepsy surgery evaluation from primary and secondary care centers and; (ii) possible factors associated with this delay. Methods: We reviewed the database of patients with MTLE referred to our center for epilepsy surgery in the last 5 years. Patients included had unequivocal MTLE-HS. Factors evaluated were age of onset, seizure types and frequency; presence of status epilepticus(SE), history of febrile seizures; number of AEDs used;family history of epilepsy. Statistical analysis was performed using Pearson's correlation for numerical clinical variables and ANOVA for categorical clinical variables. All variables with p-value < 0.1 were analyzed with a linear regression model. Results: 88 patients (41 [46.59%] with left MTLE-HS; 37 [42.04%] with right MTLE-HS and; 10 [11.36%] with bilateral MTLE-HS) were included. The mean age was 39.13 years(yrs) (SD 12.58 yrs) and 46 (52.27%) were women. The mean duration of epilepsy from the initial manifestation to the moment of the evaluation for epilepsy surgery was 27.26 yrs (SD 12.58) (minimum of 7 yrs; maximum of 60 yrs). Earlier age of onset was strongly correlated with a longer delay for referral (p < 0.001