Clinical Factors Related With Response to Anti-epileptics in Temporal Lobe Epilepsy With Hippocampal Sclerosis.
- Author:
Hyun Woo YANG
1
;
Woong LEE
;
Yong Tae JUNG
;
Tae Gyu HWANG
;
Sung Eun KIM
Author Information
1. Department of Neurology, Inje University College of Medicine, Busan, Korea. epidoc@inje.ac.kr
- Publication Type:Original Article
- Keywords:
Hippocampal sclerosis;
Temporal lobe epilepsy;
Pharmacoresistance
- MeSH:
Age of Onset;
Anticonvulsants;
Electroencephalography;
Epilepsy;
Epilepsy, Temporal Lobe;
Generalization (Psychology);
Humans;
Logistic Models;
Male;
Sclerosis;
Seizures;
Temporal Lobe
- From:Journal of the Korean Neurological Association
2008;26(2):104-109
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUNDS: 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.
