Impact of laterality on seizure duration in mesial temporal lobe epilepsy with hippocampal sclerosis

This study aims to evaluate differences in seizure durations in mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) based on laterality, along with other related findings.

This retrospective trial (2009-2023) at Istanbul University-Cerrahpasa's VEM Unit reviewed patients diagnosed with MTLE-HS via MRI and/or postoperative histopathology. Demographic data, epilepsy duration, and MTLE laterality were recorded. Seizure durations (excluding bilateral tonic-clonic periods) were analyzed, including the shortest, longest, and average seizure durations per admission. The occurrence of prolonged seizures without progression to bilateral tonic-clonic seizures (PS) was also documented.

The study included 82 participants, with 58.5% (n = 48) left-sided and 41.5% (n = 34) right-sided MTLE-HS cases. The shortest recorded seizure duration showed no significant difference between sides (p > 0.05), but the longest seizure was significantly longer in right-sided MTLE-HS (p = 0.014). The mean seizure duration per patient was also significantly longer in the right-sided group (p = 0.035). PS occurred in 17.1% (n = 14) of participants, with a significantly higher incidence in right-sided MTLE-HS (p = 0.002).

This study suggests that seizure durations may be longer in right-sided (non-dominant) MTLE-HS compared to left-sided (dominant) cases, contributing new insights into the lateralization of MTLE-HS.