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Published on: December 18, 2016
Patterns of seizure control in patients with mesial temporal lobe epilepsy with and without hippocampus sclerosis
Ana Carolina Coan1, Brunno M Campos1, Felipe P G Bergo1
1Laboratório de Neuroimagem, Departamento de Neurologia, Universidade Estadual de Campinas, Campinas, SP, Brazil.
Objective:
Patients with mesial temporal lobe epilepsy (MTLE) may present unstable pattern of seizures. We aimed to evaluate the occurrence of relapse-remitting seizures in MTLE with (MTLE-HS) and without (MTLE-NL) hippocampal sclerosis.
Method:
We evaluated 172 patients with MTLE-HS (122) or MTLE-NL (50). Relapse-remitting pattern was defined as periods longer than two years of seizure-freedom intercalated with seizure recurrence. "Infrequent seizures" was considered as up to three seizures per year and "frequent seizures" as any period of seizures higher than that.
Results:
Thirty-seven (30%) MTLE-HS and 18 (36%) MTLE-NL patients had relapse-remitting pattern (X2, p = 0.470). This was more common in those with infrequent seizures (X2, p < 0.001). Twelve MTLE-HS and one MTLE-NL patients had prolonged seizure remission between the first and second decade of life (X2, p = 0.06).
Conclusion:
Similar proportion of MTLE-HS or MTLE-NL patients present relapse-remitting seizures and this occurs more often in those with infrequent seizures.
Insights
Mesial temporal lobe epilepsy (MTLE) patients, with or without hippocampal sclerosis (HS), show similar rates of relapse-remitting seizures. This pattern is more frequent in patients experiencing infrequent seizures.
Area of Science:
- Neurology
- Epileptology
- Clinical Neuroscience
Background:
- Mesial temporal lobe epilepsy (MTLE) is characterized by potentially unstable seizure patterns.
- Understanding seizure recurrence is crucial for managing MTLE patients.
Purpose of the Study:
- To investigate the occurrence of relapse-remitting seizures in MTLE patients with hippocampal sclerosis (MTLE-HS) compared to those without (MTLE-NL).
Main Methods:
- A cohort of 172 MTLE patients (122 MTLE-HS, 50 MTLE-NL) was analyzed.
- Relapse-remitting seizures were defined as >2 years of seizure freedom followed by recurrence.
- Seizure frequency was categorized as infrequent (≤3/year) or frequent (>3/year).
Main Results:
- The relapse-remitting pattern was observed in 30% of MTLE-HS and 36% of MTLE-NL patients (p=0.470).
- This pattern was significantly more common in patients with infrequent seizures (p<0.001).
- Prolonged seizure remission was noted in 12 MTLE-HS and 1 MTLE-NL patient between the first and second decade of life (p=0.06).
Conclusions:
- The proportion of patients with relapse-remitting seizures is similar in MTLE-HS and MTLE-NL.
- Relapse-remitting seizure patterns are more prevalent in MTLE patients with infrequent seizures.
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