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Journal of Neurology

, Volume 264, Issue 5, pp 875–881 | Cite as

Medial temporal lobe epilepsy associated with hippocampal sclerosis is a distinctive syndrome

  • Young Joo No
  • Chiara Zavanone
  • Franck Bielle
  • Vi-Huong Nguyen-Michel
  • Yves Samson
  • Claude Adam
  • Vincent Navarro
  • Sophie DupontEmail author
Original Communication

Abstract

Epileptic syndromes are distinctive disorders with specific features, which when taken together, permit a specific diagnosis. There is actually a debate on that medial temporal lobe epilepsy with hippocampal sclerosis is an epileptic syndrome. To address this issue, we searched for discriminative semiological features between temporal lobe epilepsy patients with hippocampal sclerosis (TLE-HS patients or group 1), TLE patients with medial structural lesion other than hippocampal sclerosis or in MRI-negative cases with medial onset on further investigations (group 2) and lateral TLE patients (LTLE or group 3). We retrospectively collected data from medical and EEG-video records of 523 TLE patients, referred for surgery to the Pitié-Salpêtrière Epileptology Unit between 1991 and 2014. We identified 389 patients belonging to group 1, 61 patients belonging to group 2, and 73 patients belonging to group 3 and performed a comparative analysis of their clinical data and surgical outcomes. TLE-HS patients (group 1): (1) began epilepsy earlier (11 ± 9 vs. 20 ± 10 vs. 15 ± 9 years); (2) exhibited more frequently early febrile convulsions (FC) (59 vs 7 vs 5%); (3) presented more: ictal gestural automatisms (90 vs 54 vs 67%), dystonic posturing (47 vs 20 vs 23%), and secondary generalized tonic–clonic seizures (GTCS) (70 vs 44% vs 48%) as compared to both groups 2 and 3 patients (all p < 0.001). With respect to auras, abdominal visceral auras were more reported by TLE-HS than by LTLE patients (49 vs 16%). Three cardinal criteria correctly classified 94% of patients into TLE-HS group: history of FC, dystonic posturing, and secondary GTCS. Postoperative outcome was significantly better in TLE-HS group than in the two other groups (p = 0.03 and 0.003). Our study demonstrates that cardinal criteria are reliably helpful to distinguish patients with TLE-HS from those with other TLE and may allow considering TLE-HS as a distinctive syndrome.

Keywords

Medial temporal lobe epilepsy Hippocampal sclerosis Lateral lobe epilepsy Syndrome 

Notes

Compliance with ethical standards

Conflicts of interest

The authors have nothing to declare.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Rehabilitation UnitAP-HP, GH Pitie-Salpêtrière-Charles FoixParisFrance
  2. 2.Department of NeuropathologyAP-HP, GH Pitie-Salpêtrière-Charles FoixParisFrance
  3. 3.Department of Clinical NeurophysiologyAP-HP, GH Pitie-Salpêtrière-Charles FoixParisFrance
  4. 4.Stroke Unit, Hôpital de la Pitié-SalpêtrièreAP-HP, GH Pitie-Salpêtrière-Charles FoixParisFrance
  5. 5.Brain and Spine Institute (ICM; INSERM UMRS1127, CNRS UMR7225, UPMC)ParisFrance
  6. 6.Sorbonne University, UPMC Univ. Paris 06ParisFrance
  7. 7.Epileptology UnitAP-HP, GH Pitie-Salpêtrière-Charles FoixParisFrance
  8. 8.Epileptology Unit and Rehabilitation UnitHôpital de la SalpêtrièreParis Cedex 13France

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