Clinical analysis on benign temporal lobe epilepsy with hippocampal sclerosis

Abstract

Objective To observe the drug response of patients with benign temporal lobe epilepsy with hippocampal sclerosis (TLE-HS), and to summarize the clinical characteristics of patients with good drug response. Methods A total of 46 benign TLE-HS patients who were treated by anti-epileptic drugs (AEDs) and followed-up for at least 2 years with seizure-free periods longer than 12 months were enrolled in benign TLE-HS group and 51 AEDs-resistant patients were enrolled in control group. Demographic data, early sudden damage factor, family history of epilepsy, clinical symptoms, interictal EEG abnormality, side of hippocamal sclerosis and drug strategy were noted and compared between 2 groups. Multivariate forward Logistic regression was used to analyze the influencing factors of good drug response to TLE-HS. Results Age of onset ( P = 0.041), duration ( P = 0.001), history of febrile seizure ( P = 0.019), initial seizure frequency ( P = 0.001) and drug strategy ( P = 0.000) were statistically different between 2 groups. Age, sex, perinatal injury, encephalitis, traumatic brain injury (TBI), family history of epilepsy, status epilepticus (SE), cognitive impairment, mental disturbance, seizure type, aura, interictal EEG abnormality and side of hippocamal sclerosis were not statistically different between 2 groups ( P > 0.05, for all). History of febrile seizure was risk factor for benign TLE-HS ( OR = 3.405, 95%CI: 1.080-10.737; P = 0.037), while low initial seizure frequency ( OR = 0.275, 95% CI: 0.100-0.758; P = 0.013) and monotherapy ( OR = 0.135, 95% CI: 0.049-0.373; P = 0.000) were protective factors for good drug response. Conclusions Benign TLE - HS often occurs in late adolescence. In the early stage, seizure frequency is low and the occurrence of febrile seizure is rare. Monotherapy of carbamazepine or oxcarbazepine may achieve good therapeutic effect. DOI: 10.3969/j.issn.1672-6731.2016.10.012