Age At Onset Predicts Good Seizure Outcome In Sporadic Non-Lesional and Mesial Temporal Sclerosis Based Temporal Lobe Epilepsy

Umberto Aguglia (1) , Ettore Beghi (2) , Angelo Labate (3) , Francesca Condino (4) , Vittoria Cianci (1) , Laura Mumoli (1) , Sara Gasperini (1) , Aldo Quattrone (1) , Antonio Gambardella (1)

1 Regional Epilepsy Center, Reggio Calabria
2 Laboratory of Neurologic Diseases, Mario Negri Institute, Milan
3 University of Catanzaro
4 Institute of Neurological Sciences, National Research

Purpose. To study prognosis and prognostic predictors of sporadic, non-lesional temporal lobe epilepsy (TLE). Method. Four hundred seventy-four patients with TLE were consecutively seen from April 1987 to April 2004. One hundred-ninety had a sporadic, non lesional TLE and a follow-up longer than two years. Two hundred eighty four patients were excluded because of family history for TLE, incomplete history, poor compliance with treatment, psychogenic seizures, no brain MRI study, presence of intracranial lesions except for scattered T2-hyperintense spots on hemispheric white matter or mesial temporal sclerosis (MTS). The following prognostic predictors were considered: age at onset of epilepsy, gender, family history of non-TLE or febrile seizures, perinatal factors, history of febrile seizures, ictal phenomena, MTS, and interictal EEG. The end point was time to 24-month seizure freedom after treatment onset. Chi-square test, Student's t test, Kaplan-Meier survival curves with log-rank test (univariate analysis) and Cox proportional-hazards regression models (multivariate analysis) were used to assess seizure prognosis and prognostic predictors. Results. At univariate analysis, patients achieving 24-month seizure freedom had significantly older age at onset of epilepsy (33.5 +19.9 vs. 17.2 +14.4 years), lower occurrence of febrile seizures (11.0% vs 24.4%) and MTS (19.0% vs. 35.6%). The chance of remission was directly correlated to the age at onset of seizures and inversely correlated to a history of febrile seizures and to the presence of MTS. At multivariate analysis, age at onset of epilepsy was the only significant prognostic predictor. Conclusion. Older age at onset predicts better prognosis in sporadic, non-lesional TLE

Mots clés: EPIDEMIOLOGY; EPILEPSY

Umberto Aguglia, Ettore Beghi, Angelo Labate, Francesca Condino, Vittoria Cianci, et al.. Age At Onset Predicts Good Seizure Outcome In Sporadic Non-Lesional and Mesial Temporal Sclerosis Based Temporal Lobe Epilepsy. Journal of Neurology, Neurosurgery and Psychiatry, 2010, 82 (5), pp.555. ⟨10.1136/jnnp.2010.217620⟩. ⟨hal-00587975⟩