Abstracts

RATIONALE: Hippocampal sclerosis (HS) is the most common cause of medically intractable temporal lobe epilepsy (TLE). Traditionally, HS has been considered to be a sporadic condition; a concept supported by studies on identical twins. However, the high incidence of the coexistence of HS with developmental lesions (dual pathology) raises the question of a possible familial component to this entity. In this study, we investigated the presence of a positive family history of epilepsy in patients with TLE due to HS.
At the end of this activity, the participants should be aware of a possible genetic role in HS.
METHODS: Fifty-five consecutive patients with TLE who met volumetric MRI criteria for the diagnosis of HS were studied. The patients and/or family members were contacted over the telephone, and a thorough family history of at least 3 generations was obtained.
RESULTS: Of the 55 patients, 22 (40%) reported having another family member with seizures. Seven patients had more than one affected family member. Of the 31 affected family members, seven (23%) had definite etiologies for their seizures, including one family member with bilateral HS. Thirteen family members (42%) had no apparent etiology for their seizures, and three (10%) were found not to have seizures. There was insufficient information about eight (26%) affected family members to determine if they had epilepsy. Therefore, of the 22 patients reporting family members with epilepsy, we were able to confirm a positive family history in 15 patients (27%).
Both the reported (40%) and verified (27%) prevalence of epilepsy in family members of patients with HS were significantly different (p [lt] 0.01) from that in the general population.
CONCLUSIONS: Patients with HS have a high incidence (27%) of family members with epilepsy. This suggests that HS is found in individuals with an increased genetic susceptibility for seizures.