Clinical characteristics of nonlesional temporal lobe epilepsy
10.3760/cma.j.issn.1006-7876.2020.02.005
- VernacularTitle: 磁共振成像阴性颞叶癫痫的临床特点分析
- Author:
Linmei YE
1
;
Cong CHEN
2
;
Fang DING
2
;
Linglin YANG
2
;
Bo JIN
3
;
Shuang WANG
2
Author Information
1. Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China (Ye Linmei now is working in the Department of Neurology, Hengdian Wenrong Hospital, Dongyang, Zhejiang 322118, China)
2. Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
3. Department of Neurology, Zhejiang Provincial People′s Hospital, Hangzhou 310009, China
- Publication Type:Clinical Trail
- Keywords:
Temporal lobe epilepsy;
Magnetic resonance imaging;
Hippocampus;
Memory
- From:
Chinese Journal of Neurology
2020;53(2):103-109
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characteristics, memory and neuroimaging features of nonlesional temporal lobe epilepsy (TLE-NL).
Methods:Forty-four patients with TLE-NL and 53 patients with unilateral temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) were recruited from the Second Affiliated Hospital of Zhejiang University from September 1st 2012 to August 31st 2017. The clinical characteristics were systematically analyzed and compared between TLE-NL and TLE-HS. Twenty healthy volunteers were also recruited. Memory assessment and high resolution magnetic resonance imaging (MRI) scanning were completed in the patients and healthy volunteers. Volume and shape of the hippocampus were compared between patients and healthy volunteers.
Results:Compared with the TLE-HS, TLE-NL patients showed later seizure onset ((24.3±12.6) vs (15.8±10.3) years; t=3.684, P<0.01), shorter duration of epilepsy ((4.00 (2.00, 8.75)) vs (14.00 (7.50, 22.00)) years; Z=-4.675, P<0.01), less history of febrile convulsions (4.5% (2/44) vs 62.3% (33/53); χ2=32.270, P<0.01) and lower incidence of pharmacoresistant epilepsy (47.7% (21/44) vs 84.9% (45/53); χ2=15.282, P<0.01). However, there were no statistically significant differences between TLE-NL and TLE-HS in sex ratio, family history of epilepsy, lateralization of the epileptogenic zone, presence of aura, seizure types and seizure frequency. TLE-NL patients had normal memory quotient compared to normal controls (105.2±17.4 vs 103.8±16.2; P=1.000), while TLE-HS patients had significant memory impairment compared to normal controls (84.5±20.3 vs 103.8±16.2; P<0.01). Compared to normal controls, TLE-NL patients did not have significant alteration in hippocampal volume and shape, while TLE-HS patients had significant atrophy in the ipsilateral hippocampus ((2 953±481) mm3 vs (4 431±505) mm3; P<0.01), and shape analysis showed significant atrophy in the head and body of the hippocampus.
Conclusion:TLE-NL has different characteristics compared with TLE-HS, including later seizure onset, shorter duration of epilepsy, less history of febrile convulsions, better response to antiepileptic drugs, and no significant memory impairment and hippocampal atrophy.
