Outcome of surgical treatment in familial mesial temporal lobe epilepsy |
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Authors: | Kobayashi Eliane D'Agostino Maria Daniela Lopes-Cendes Iscia Andermann Eva Dubeau François Guerreiro Carlos A M Schenka André A Queiroz Luciano S Olivier André Cendes Fernando Andermann Frederick |
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Affiliation: | Department of Neurology, University of Campinas, UNICAMP, Campinas, SP, Brazil. |
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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. |
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Keywords: | Surgery Hippocampal atrophy Familial mesial temporal lobe epilepsy |
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