Abstracts

RATIONALE: In a previous study, we have illustrated that the Apolipoprotein E (APOE) polymorphisms are not a general risk factor for mild non-lesional temporal lobe epilepsy (nTLE). There has been recent evidence, however, that APOEe4 might be associated with earlier onset of chronic TLE, but the study group was small and another study did not confirm this finding. To better address this issue we aimed to study a larger group of patients with mild nTLE. We also wished to evaluate if febrile convulsions (FCs) in early childhood could independently influence the age at onset in such nTLE patients.
METHODS: The study group consisted of consecutive 115 patients (66 women and 49 men) who had received a diagnosis of nTLE after a comprehensive clinical and laboratory study. In all patients seizures were well controlled after appropriate antiepileptic medication. Twelve/115 (10%) patients had had FCs. Age at seizure onset was the age of the subject at their first unequivocal seizure. The ApoE polymorphisms were determined from blood samples by standard methods.
RESULTS: The distribution of the ApoE alleles in the patients was not significantly different from that observed in age- and sex-matched normal individuals. Eleven/115 (9.6%) nTLE patients carrying the epsilon4 allele had an onset of habitual seizures on average 7 years earlier than patients not carrying such allele (26.6 [plusminus] 20.6 years vs 33.9[plusminus] 20.7 years), but this difference did not reach a statistical significance. Importantly, the 12/115 patients with previous FCs had a significant earlier age at onset (8.6 [plusminus] 6.9 years) of their epilepsy.
CONCLUSIONS: We illustrated that nTLE patients with a previous history of FCs had a significant earlier onset of their habitual seizures. The ApoE polymorphisms did not have a similar influence, even if age at onset of nTLE tended to be lower in patients carrying the epsilon4 allele.