Prognostic factors in patients with mesial temporal lobe epilepsy

Francesca Pittau, Francesca Bisulli, Roberto Mai, Jean Elia Fares, Luca Vignatelli, Angelo Labate, Ilaria Naldi, Patrizia Avoni, Antonia Parmeggiani, Margherita Santucci, Diana Capannelli, Lidia Di Vito, Antonio Gambardella, Agostino Baruzzi, Paolo Tinuper

Research output: Contribution to journalArticle

Abstract

Purpose: To disclose clinical, electrophysiologic, and neuroradiologic factors correlated to prognosis in patients with mesial temporal lobe epilepsy (MTLE). Methods: One hundred thirty-six MTLE patients were studied for family history, clinical characteristics, instrumental data [electroencephalography (EEG), video-EEG, neuroimaging], and outcome. The population was divided into drug-resistant (DR: 108 patients, 79.4%) and non-drug-resistant (NDR: 28 patients, 20.6%) groups; all variables were analyzed in the two groups. Results: The comparison between the two groups shows a relation between resistance to therapy and febrile seizures (FS) (DR 43.5% vs. NDR 17.8%, p = 0.008), mesial temporal sclerosis (MTS) (DR 64.8% vs. NDR 32.1%, p = 0.0025), early age at seizure onset (DR 23.1% vs. NDR 3.6% p = 0.0160), and epileptiform interictal abnormalities (DR 89.7% vs. NDR 68%, p = 0.010). FS were more frequent in patients with MTS than in patients without (46.28% vs. 26.3%, p = 0.0199). Sixty-nine patients underwent surgery and 85.3% of them had a good outcome. Conclusion: MTLE 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 must lead to early surgical management. This study shows that FS, MTS, early age at seizure onset, and epileptiform interictal abnormalities are negative prognostic factors and that FS are related to MTS.

Original languageEnglish
Pages (from-to)41-44
Number of pages4
JournalEpilepsia
Volume50
Issue numberSUPPL. 1
DOIs
Publication statusPublished - Jan 2009

Keywords

  • Epilepsy surgery
  • Febrile convulsions
  • Mesial temporal sclerosis
  • Prognosis
  • Temporal lobe epilepsy

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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  • Cite this

    Pittau, F., Bisulli, F., Mai, R., Fares, J. E., Vignatelli, L., Labate, A., Naldi, I., Avoni, P., Parmeggiani, A., Santucci, M., Capannelli, D., Di Vito, L., Gambardella, A., Baruzzi, A., & Tinuper, P. (2009). Prognostic factors in patients with mesial temporal lobe epilepsy. Epilepsia, 50(SUPPL. 1), 41-44. https://doi.org/10.1111/j.1528-1167.2008.01969.x