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Mesial temporal lobe epilepsy in Singapore
Singapore Medical Journal
|December 1, 1995
Summary
Mesial temporal lobe epilepsy (MTLE) in Singaporean patients shows similar characteristics to Caucasian populations. Surgical outcomes for MTLE are promising, with many patients achieving seizure freedom or significant reduction.
Area of Science:
- Neurology
- Epileptology
- Neurosurgery
Background:
- Mesial temporal lobe epilepsy (MTLE) secondary to mesial temporal sclerosis is a distinct epilepsy syndrome.
- It is a surgically remediable condition, offering hope for intractable epilepsy.
- Understanding population-specific characteristics is crucial for diagnosis and treatment.
Purpose of the Study:
- To characterize 26 Singaporean cases of MTLE.
- To correlate clinical, electroencephalographic (EEG), and magnetic resonance imaging (MRI) findings with surgical outcomes.
- To compare these characteristics with published data on Caucasian populations.
Main Methods:
- Retrospective analysis of 26 Singaporean patients with MTLE.
- Clinical evaluation, EEG (interictal and ictal scalp EEG), and MRI assessments.
- Surgical intervention and follow-up for at least 6 months in 17 patients.
Main Results:
- 65% of patients had initial seizures associated with febrile illness; 73% had onset before age 10.
- Median interval to intractable seizures was 3.75 years; 80.7% experienced aura and lateralizing signs.
- MRI revealed hippocampal abnormalities, predominantly asymmetric atrophy; EEG showed unilateral temporal spikes and lateralized ictal activity.
Conclusions:
- Singaporean MTLE cases share significant similarities with Caucasian cohorts in clinical presentation and MRI findings.
- Good surgical outcomes were observed, with 12 patients seizure-free and 5 with minimal seizures post-operation.
- MTLE in this population is a surgically remediable epilepsy syndrome with predictable characteristics.