Long-term outcome of treatment-naïve patients with mesial temporal lobe epilepsy with hippocampal sclerosis: A retrospective study in a single center.

Autor: Cho S; Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea., Lee HJ; Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Neurology, Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Republic of Korea., Lee SH; Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Neurology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea., Kim KM; Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea., Chu MK; Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea., Kim J; Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea., Heo K; Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: kheo@yuhs.ac.
Jazyk: angličtina
Zdroj: Seizure [Seizure] 2024 Apr; Vol. 117, pp. 36-43. Date of Electronic Publication: 2024 Jan 27.
DOI: 10.1016/j.seizure.2024.01.018
Abstrakt: Purpose: This study aimed to describe long-term treatment outcomes of treatment-naïve patients with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS).
Methods: A retrospective review was conducted of treatment-naïve patients with MTLE-HS who visited the Yonsei Epilepsy Clinic from April 2000 to April 2022 and were followed up for at least 2 years. Seizure freedom (SF) was defined as no seizures or auras only for >1 year, and complete SF was defined as no seizures including auras for >1 year.
Results: Eighty-four treatment-naïve patients with MTLE-HS with a median follow-up of 122 months were included. Except for one patient who underwent early surgical treatment, of the remaining 83 patients, 31 (37.3 %) achieved SF and remained in remission, 38 (45.8 %) had fluctuations in seizure control, and 14 (16.9 %) never achieved SF. Additionally, 18 (21.7 %) patients achieved complete SF and remained in remission, 42 (50.6 %) showed fluctuations, and 23 (27.7 %) never achieved complete SF. Fifty-three (63.9 %) patients achieved SF and 34 (41.0 %) achieved complete SF at their last visit. Older age at epilepsy onset, male sex, low pretreatment seizure density, history of central nervous system infection before age 5, absence of aura, and fewer antiseizure medications in the final regimen were associated with favorable outcome. Of the 84 patients, 11 (13.1 %) underwent temporal lobectomy.
Conclusions: Medical treatment outcomes in treatment-naïve MTLE-HS were relatively better than previously reported outcomes in MTLE-HS, although frequent fluctuations in seizure control were observed.
Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest.
(Copyright © 2024. Published by Elsevier Ltd.)
Databáze: MEDLINE
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