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Outcome of Surgical Treatment in Familial Mesial Temporal Lobe Epilepsy
Author(s) -
Kobayashi Eliane,
D'Agostino Maria Daniela,
LopesCendes Iscia,
Andermann Eva,
Dubeau François,
Guerreiro Carlos A. M.,
Schenka André A.,
Queiroz Luciano S.,
Olivier André,
Cendes Fernando,
Andermann Frederick
Publication year - 2003
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1046/j.1528-1157.2003.06503.x
Subject(s) - ictal , hippocampal sclerosis , temporal lobe , refractory (planetary science) , medicine , epilepsy , surgery , magnetic resonance imaging , atrophy , epilepsy surgery , central nervous system disease , radiology , psychiatry , physics , astrobiology
Summary: 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.