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Mesial temporal lobe epilepsy with childhood febrile seizure
A A Asadi-Pooya1, M Nei1, C Rostami1
1Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA.
Insights
Childhood febrile seizures (FS) do not alter the clinical presentation or surgical outcomes for patients with mesial temporal sclerosis and temporal lobe epilepsy (MTS-TLE). History of FS is not a distinguishing factor for MTS-TLE patient characteristics or surgical success.
Area of Science:
- Neurology
- Epileptology
- Neurosurgery
Background:
- Mesial temporal sclerosis (MTS) is a common cause of drug-resistant temporal lobe epilepsy (TLE).
- The role of childhood febrile seizures (FS) in the development and progression of MTS-TLE is not fully understood.
- Investigating potential differences in patients with and without a history of FS is crucial for understanding disease heterogeneity.
Purpose of the Study:
- To compare demographic and clinical manifestations between patients with MTS-TLE with and without a history of childhood FS.
- To evaluate and compare surgical treatment outcomes in these two patient groups.
- To determine if childhood FS history influences MTS-TLE characteristics or predicts surgical success.
Main Methods:
- Retrospective analysis of 262 patients with drug-resistant MTS-TLE who underwent epilepsy surgery.
- Patients were categorized based on the presence or absence of childhood FS history.
- Comparison of clinical characteristics and postoperative seizure outcomes (seizure-free vs. relapsed) between groups.
Main Results:
- No significant differences were observed in demographic or clinical characteristics between MTS-TLE patients with and without childhood FS.
- A history of childhood FS was reported by 35.1% of the patients.
- Postoperative seizure outcomes were statistically similar between the FS and non-FS groups (P = 0.19).
Conclusions:
- In patients with MTS as the pathological basis for TLE, a history of childhood FS does not differentiate clinical manifestations.
- Childhood FS history does not serve as a predictive factor for surgical treatment outcomes in MTS-TLE.
- The presence of MTS in TLE diminishes the distinguishing value of childhood FS history regarding patient characteristics and surgical prognosis.
Objectives:
To evaluate the demographic and clinical manifestations of patients with mesial temporal sclerosis and temporal lobe epilepsy (MTS-TLE) with childhood febrile seizure (FS) and establishing the potential differences as compared to those without FS. We also investigated the surgery outcome in these two groups of patients.
Materials And Methods:
In this retrospective study, all patients with a clinical diagnosis of drug-resistant TLE due to mesial temporal sclerosis, who underwent epilepsy surgery at Jefferson Comprehensive Epilepsy Center, were recruited. Patients were prospectively registered in a database from 1986 through 2014. Postsurgical outcome was classified into two groups; seizure-free or relapsed. Clinical manifestations and outcome were compared between patients with MTS-TLE with FS and those without FS.
Results:
Two hundred and sixty-two patients were eligible for this study. One hundred and seventy patients (64.9%) did not have FS in their childhood, while 92 patients (35.1%) reported experiencing FS in their childhood. Demographic and clinical characteristics of these two groups of patients were not different. Postoperative seizure outcome was not statistically different between these two groups of patients (P = 0.19).
Conclusions:
When MTS is the pathological substrate of TLE, clinical manifestations and response to surgical treatment of patients are very similar in patients with history of febrile seizure in their childhood compared to those without such an experience. In other words, when the subgroup of patients with MTS-TLE and drug-resistant seizures is examined history of childhood febrile seizure loses its value as a distinguishing factor in characteristics or predictive factor for surgery outcome.
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