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Journal of the Korean Child Neurology Society 1999;7(1):63-70.
Published online October 30, 1999.
Prognostic Factors for Non-lesional Temporal Lobe Epilepsy.
Gye Ri Jeon, Sung Hwan Kim
Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea.
Abstract
PURPOSE
Temporal lobe epilepsy in infants and children have been the focus of many clinical investigations and observations. Several prognostic aspects of nonlesional temporal lobe epilepsy (NLTLE) in childhood remain unclear or controversial. This study was aimed to evaluate the clinical characteristics of NLTLE influencing short-term remission and whether the short-term seizure outcome has any impact on long-term prognosis. METHODS: The study was performed between June 1994 and August 1997. There were 32 newly-referred patients who had diagnosed of NLTLE from the data registry of Pediatric Epilepsy Clinic of Ajou University Medical Center. The patients identification was based on the careful review of hospital records, EEGs, and brain MRI. We have evaluated 6 months terminal remission rate (6M-TR) at one year of continuous antiepileptic drug (AED) treatment as short-term outcome. The predictive value of clinical parameters of NLTLE was comparatively analyzed between the patient who attained 6M-TR and who did not. To identify the long-term prognosis in NLTLE, we analyzed continuous seizure free rate during the next one year and compared between the patient who attained 6M-TR and who did not. RESULTS: 1) Among total 32 NLTLE patients, 18 (56.2%) patients attained 6M-TR at one year of AED treatment. 2) We cannot find any statistically significant clinical parameters influencing the short-term outcome between the two groups : age of onset (P=0.467), duration of illness (P=0.408), seizure type (P=0.725), abnormality of EEG (P=0.473), MRI findings (hippocampal sclerosis or temporal neocortical atrophy) (P=0.685). However, a previous history of perinatal asphyxia (P=0.367) and febrile seizure (P=0.253) were not statistically significant but those clinical parameters suggest clinical significance of influencing short-term outcome of NLTLE. 3) Patients with 6M-TR have showed the next one year remission in significantly higher proportion (77.8%) than those without 6M-TR (28.6%) (P=0.001). CONCLUSION: Early short-term outcome of NLTLE is relatively good and significant proportion of patients with early 6M-TR enters the next one year remission period. So we conclude that short-term remission of NLTLE may be an important determinant in predicting long-term prognosis.
Key Words: NLTLE, 6M-TR, Long-term prognosis


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