Abstracts

Hippocampal sclerosis is known to strongly correlate with the medical intractability of mesial temporal lobe epilepsy. However, it is possible that the informations about this has been biased due to the improper selection of the sampling obtained from severe cases of tertiary epilepsy center and surgical epilepsy field. We tried to investigate the influence of hippocampal sclerosis on the pharmacoresistance in mesial temporal lobe epilepsy by group comparison study. The fifty patients with complex partial seizures of temporal lobe origin, and temporal spike on electroencephalography and/or hippocampal sclerosis on brain magnetic resonance imaging were selected. Follow-up period of them were more than 2 years. The patients who had seizure or seizures during the last 1-year period and had already been in the adequate doses of two or more antiepileptic drugs were considered to be the poorly controled epileptics. Five of 17 patients without hippocampal sclerosis (29.4%) and 24 of 33 patients with hippocampal sclerosis (72.7%) were poorly controled by medication and the difference was significant (p = 0.003, chi-square). Other factors, including sex, age of onset, febrile convulsion, secondary generalization, familial history of epilepsy, duration of disease, and delay of initial therapy had no significant effects on medical response (p [gt] 0.05). The only independent predictor of intractable epilepsy after multiple logistic regression analysis was also hippocampal sclerosis (p = 0.005). The medical response in mesial temporal lobe epilepsy was significantly associated with hippocampal sclerosis. The hippocampal sclerosis on brain magnetic resonance imaging itself may be a crucial factor determining the pharmacoresistance of mesial temporal lobe epilepsy.