Phenotypic characteristics of temporal lobe epilepsy: the impact of hippocampal sclerosis

Acta Neurol Scand Suppl. 2009;(189):8-13. doi: 10.1111/j.1600-0404.2009.01205.x.


Objectives: Whether mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) is a condition with a unique biological background that can be delineated from other TLE, is unresolved. Here we performed a comparative analysis of two TLE patient cohorts - one cohort with HS and one without HS - in order to identify phenotypic characteristics specifically associated with MTLE-HS.

Methods: Epidemiological data and clinical and diagnostic features were compared between patients with MTLE-HS and TLE patients without HS. When appropriate, data were compared with healthy controls.

Results: Fifty-six (26%) patients were diagnosed with MTLE-HS and 162 (74%) with other TLE. Age at epilepsy onset was lower in patients with MTLE-HS (P = 0.003) than in TLE patients without HS. Incidence of simple partial seizures was higher in the MTLE-HS group (P = 0.006), as were complex partial seizures (P = 0.001), ictal psychiatric symptoms (P = 0.015), and autonomic symptoms (P < 0.001). Interictal psychiatric symptoms, including depression, were less frequent in MTLE-HS (P = 0.043). MTLE-HS patients had a higher incidence of childhood febrile seizures (FS; P = 0.043) than TLE patients without HS. In contrast, the former group had the lower frequency of first-grade family members with childhood FS (P = 0.019).

Conclusions: We identified phenotypic characteristics that distinguish MTLE-HS from other types of TLE. These characteristics will be important in diagnostics, treatment, and determination of prognosis, and provide a basis for future phenotype-genotype studies.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Aged
  • Anxiety / etiology
  • Cohort Studies
  • Depression / etiology
  • Diagnosis, Differential
  • Epilepsy, Temporal Lobe / genetics*
  • Epilepsy, Temporal Lobe / pathology*
  • Female
  • Hippocampus / pathology*
  • Humans
  • Male
  • Middle Aged
  • Phenotype*
  • Sclerosis