Outcome of surgical treatment in familial mesial temporal lobe epilepsy.

Abstract:

PURPOSE:To describe postoperative outcome in patients with familial mesial temporal lobe epilepsy (FMTLE). METHODS:We studied FMTLE patients who underwent surgical treatment for refractory seizures. FMTLE was defined when at least two individuals in a family had a clinical EEG diagnosis of MTLE. Preoperative investigation included magnetic resonance imaging (MRI), interictal/ictal EEGs, and neuropsychological evaluation. We used Engel's classification for postoperative outcome. RESULTS:To date, 20 FMTLE patients have been operated on, with 1.6 to 9.8 years of follow-up (mean, 5.5 years). Hippocampal atrophy (HA) and other signs of mesial temporal sclerosis (MTS) were present in 18 patients (15 unilateral). Seizures were recorded in 19 patients. Seventeen (85%) patients are in class I. Two patients had normal hippocampal volumes (HcV): one (5%) is in class II and the other (5%) in class IV (extratemporal seizures developed after surgery). One (5%) patient had bilateral HA and is in class III. Qualitative histopathology showed MTS with different degrees of severity. CONCLUSIONS:Refractory FMTLE patients have good surgical outcome when unilateral or clearly asymmetric HA is identified. Preoperative investigation should be the same as that in patients with sporadic refractory MTLE.

journal_name

Epilepsia

journal_title

Epilepsia

authors

Kobayashi E,D'Agostino MD,Lopes-Cendes I,Andermann E,Dubeau F,Guerreiro CA,Schenka AA,Queiroz LS,Olivier A,Cendes F,Andermann F

doi

10.1046/j.1528-1157.2003.06503.x

subject

Has Abstract

pub_date

2003-08-01 00:00:00

pages

1080-4

issue

8

eissn

0013-9580

issn

1528-1167

pii

06503

journal_volume

44

pub_type

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