J Korean Neurol Assoc.  2008 May;26(2):104-109.

Clinical Factors Related With Response to Anti-epileptics in Temporal Lobe Epilepsy With Hippocampal Sclerosis

• Yang HW
• Lee W
• Jung YT
• Hwang TG
• Kim SE

Abstract

BACKGROUND
S: Temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) is not always intractable to antiepileptic drugs (AEDs). To identify the responsiveness to AEDs and related clinical factors in TLE-HS, we performed this study.
METHODS
Consecutive 100 (51 men, mean age=30.2+/-6.6, age range=19-50) patients with TLE-HS were divided into two groups by their responsiveness to AEDs. Intractable TLE-HS was defined if they had any seizures for the preceding year with at least two AEDs. Clinical factors were analyzed to find the association of the responsiveness to AEDs.
RESULTS
Intractable TLE-HS was found in 68% of patients. The younger age of onset (12+/-4 vs. 31+/-8 years, p<0.0001), longer duration of epilepsy (17+/-6 vs. 2+/-1 years, p<0.0001), more than five tonic-clonic seizures (GTCs) with secondary generalization (29.4 vs. 6.3%, p=0.0009) and bilateral epileptiform abnormalities on EEG (30.9 vs 6.3%, p=0.0054) were significantly correlated with the intractable TLE-HS. According to multiple logistic regression analysis, bilateral epileptiform abnormalities on EEG (adjusted OR=9.4, 95% CI: 1.98~44.76) and more than five GTC (adjusted OR=7.7, 95% CI: 1.60~33.39) were independently related with poor responsiveness to AEDs in TLE-HS.
CONCLUSIONS
The presence of hippocampal sclerosis does not necessarily mean intractability to AEDs. The clinical variables related with the poor response to ADEs in TLE-HS are more than five GTCs and bilateral epileptiform abnormalities on EEG.

Keyword

Hippocampal sclerosis; Temporal lobe epilepsy; Pharmacoresistance

MeSH Terms

Age of Onset
Anticonvulsants
Electroencephalography
Epilepsy
Epilepsy, Temporal Lobe
Generalization (Psychology)
Humans
Logistic Models
Male
Sclerosis
Seizures
Temporal Lobe
Anticonvulsants