Prognostic factor for medical control for seizures in patients with radiologic evidence for mesial temporal lobe sclerosis

Introduction. Patients-with mesial temporal lobe sclerosis (MTS) usually have suffered a brain insult during early childhood, a febrile convulsion inmost cases. Complex partial seizures start after a seizure free period of variable duration. These complex partial seizures have an stereotypic semiology. Often, these seizure are not controlled with medical therapy, previous studies shows a rate of control not superior of 30%. Aim. To know the prognosis for medical control of patients with MTS and to find related factors. Pastients and methods. The clinical characteristics of 51 patients with temporal lobe epilepsy and radiologic evidence of MTS (hippocampus atrophy or increased signal on T-2 or FLAIR magnetic resonance sequences). Results. 51 patients, of them 17 (34%) were men. 17 (34%) presented right MTS, 30 (60%) left MTS and 2 (4.3%) bilateral MTS. 16 patients (34.8%) referred autonomic aura, 14 (27.5%) psychic aura, 4 (7.8%) dysphasia and 13 (25.5%) no aura, in 2 (3.9%) aura were mixed: autonomic-psychic. The aura was associated to the lesion laterality (p = 0.023) and to the reference of some antecedent of cerebral aggression during early childhood (p = 0.011). Concerning to the seizure control, 15 patients (29.2%) were seizure free in the last 6 month and 36 (70.6%) remaining uncontrolled. The associated factors to the medical control were the age of onset (p = 0. 024) and the duration of the epilepsy (p = 0. 018). Conclusions. Around 29% of patients with MTS can be controlled with medical therapy. Seizure control is related with later age of onset and short duration of the epilepsy.