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KMID : 0857020020170010100
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Kosin Medical Journal
2002 Volume.17 No. 1 p.100 ~ p.104
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Clinical Features of Temporal Lobe Epilepsy due to Pathologically Proven Hippocampal Sclerosis
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Kim Kwang-Soo
Cole Andrew J
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Abstract
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Background : The commonest pathology underlying temporal lobe eilepsy is hippocampal sclerosis which is associated with febrile convulsion in young children. The purpose of this study was to determine the clinical characteristics in patients with medically refractory temporal lobe epilepsy due to hippocampal sclerosis (HS) compared to patients with temporal lobe lesions (TLL).
Methods : Records of 122 consecutive patients who underwent surgery for epilepsy from January 1993 to April 2000 were retrieved from the MGH Epilepsy Surgery Database. Fifty-eight patients with temporal lobe epilepsy due to pathologically proven HS or TLL were identified and clinical data were reviewed. Patients were divided into two groups according to pathological findings, hippocampal sclerosis group and temporal lobe lesion group. Patients with dual or normal pathology were excluded.
Results : Pathologically proven HS was present in 32 patients, and 26 patients has temporal lobe lesions (cortical dysplasia, vascular malformation, gliomas, heterotopia). Mean age at onset was 12.6±9.8 years in HS group and 19.6±10.6 years in TLL group (p=0.012). Mean duration of epilepsy was 20.6±10.4 years in HS and 11.6±9.2 years in TLL (p=0.001). Febrile convulsion was present in 12 (28.1%) of 32 patients with HS and 1 (3.8%) of 26 TLL patients (p=0.002). Family history of seizure was more frequent in HS group but not statistically significant. Age at surgery, gender, monthly seizure frequency, presence of known etiology, and the existence of aura and secondarily generalized seizure were not significantly different between the two groups.
Conclusions : Epilepsy due to HS had a significantly earlier onset, and patients lived with the epilepsy for a significantly longer duration. Presence of febrile convulsions was significantly associated with HS.
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KEYWORD
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Temporal lobe epilepsy, Hippocampal sclerosis, Clinical features
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