The relationship between aura and postoperative outcomes of epilepsy surgery in patients with mesial temporal sclerosis

Zare, Mohammad; Habibabadi, Jafar Mehvari; Moein, Houshang; Barekatain, Majid; Basiratnia, Reza; Tofangsazi, Ladan

The relationship between aura and postoperative outcomes of epilepsy surgery in patients with mesial temporal sclerosis

Authors

¹ Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

² Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

³ Department of Psychiatric, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

⁴ Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: We conducted a study to evaluate the relationship between aura types and postoperative outcomes in patients with mesial temporal sclerosis (MTS) to predict the prognosis of patients, accordingly. Materials and Methods: In this cross-sectional study, 99 patients with MTS-temporal lobe epilepsy were enrolled based on inclusion and exclusion criteria. The types of aura were evaluated, and the outcomes were categorized according to theEngel scale. Preoperative and postoperative results of patients were compared and analyzed with the Kruskal–Wallis test. Results: About 73.7% of patients had seizure-free after their surgeries. The most of patients (n = 81)were in Class I of Evaluating Engel criteria. About 36.3% had not experienced any aura before their seizures, and among those with aura, the most prevalent aura was abdominal aura in 29 patients (29.3%) followed by other types of aura and affective aura. Most of the patients in Class I, II, III, and IV of Engel scale had an abdominal aura, without aura, effective aura, and abdominal aura, respectively, but this difference was not statistically significant (P = 0.691). Conclusion: According to this study, the type of aura cannot predict postoperative outcomes in MTS patients. More studies are needed to evaluate this relation in better-planned studies with greater sample size.

Keywords

References

1.	de Boer HM, Mula M, Sander JW. The global burden and stigma of epilepsy. Epilepsy Behav 2008;12:540-6.
2.	Wieser HG, ILAE Commission on Neurosurgery of Epilepsy. ILAE commission report. Mesial temporal lobe epilepsy with hippocampal sclerosis. Epilepsia 2004;45:695-714.
3.	Engel J Jr., Brown WJ, Kuhl DE, Phelps ME, Mazziotta JC, Crandall PH. Pathological findings underlying focal temporal lobe hypometabolism in partial epilepsy. Ann Neurol 1982;12:518-28.
4.	Helmstaedter C, Loer B, Wohlfahrt R, Hammen A, Saar J, Steinhoff BJ, et al. The effects of cognitive rehabilitation on memory outcome after temporal lobe epilepsy surgery. Epilepsy Behav 2008;12:402-9.
5.	Kumlien E, Doss RC, Gates JR. Treatment outcome in patients with mesial temporal sclerosis. Seizure 2002;11:413-7.
6.	Engel J Jr., McDermott MP, Wiebe S, Langfitt JT, Stern JM, Dewar S, et al. Early surgical therapy for drug-resistant temporal lobe epilepsy: A randomized trial. JAMA 2012;307:922-30.
7.	Ferrari-Marinho T, Caboclo LO, Marinho MM, Centeno RS, Neves RS, Santana MT, et al. Auras in temporal lobe epilepsy with hippocampal sclerosis: Relation to seizure focus laterality and post surgical outcome. Epilepsy Behav 2012;24:120-5.
8.	Foldvary-Schaefer N, Unnwongse K. Localizing and lateralizing features of auras and seizures. Epilepsy Behav 2011;20:160-6.
9.	Asadi-Pooya AA, Nei M, Sharan A, Sperling MR. Type of preoperative aura may predict postsurgical outcome in patients with temporal lobe epilepsy and mesial temporal sclerosis. Epilepsy Behav 2015;50:98-100.
10.	Blume WT, Lüders HO, Mizrahi E, Tassinari C, van Emde Boas W, Engel J Jr. Glossary of descriptive terminology for ictal semiology: Report of the ILAE task force on classification and terminology. Epilepsia 2001;42:1212-8.
11.	Téllez-Zenteno JF, Hernández-Ronquillo L. A review of the epidemiology of temporal lobe epilepsy. Epilepsy Res Treat 2012;2012:1-6.
12.	Gyimesi C, Fogarasi A, Kovács N, Toth V, Magalova V, Schulz R, et al. Patients' ability to react before complex partial seizures. Epilepsy Behav 2007;10:183-6.
13.	Wieser HG, Blume WT, Fish D, Goldensohn E, Hufnagel A, King D, et al. ILAE commission report. Proposal for a new classification of outcome with respect to epileptic seizures following epilepsy surgery. Epilepsia 2001;42:282-6.
14.	Henkel A, Noachtar S, Pfänder M, Lüders HO. The localizing value of the abdominal aura and its evolution: A study in focal epilepsies. Neurology 2002; 58:271-6.
15.	Engel J Jr. Outcome with respect to epileptic seizures. Surg treat epilepsies. 1993;:609-21.
16.	King DW, Marsan CA. Clinical features and ictal patterns in epileptic patients with EEG temporal lobe foci. Ann Neurol 1977;2:138-47.
17.	Taylor DC, Lochery M. Temporal lobe epilepsy: Origin and significance of simple and complex auras. J Neurol Neurosurg Psychiatry 1987;50:673-81.
18.	Duncan JS, Sagar HJ. Seizure characteristics, pathology, and outcome after temporal lobectomy. Neurology 1987;37:405-9.
19.	Kuan YC, Shih YH, Chen C, Yu HY, Yiu CH, Lin YY, et al. Abdominal auras in patients with mesial temporal sclerosis. Epilepsy Behav 2012;25:386-90.
20.	Sperling MR, O'Connor MJ. Auras and subclinical seizures: Characteristics and prognostic significance. Ann Neurol 1990;28:320-8.
21.	Fried I, Spencer DD, Spencer SS. The anatomy of epileptic auras: Focal pathology and surgical outcome. J Neurosurg 1995;83:60-6.
22.	Manford M, Fish DR, Shorvon SD. An analysis of clinical seizure patterns and their localizing value in frontal and temporal lobe epilepsies. Brain 1996;119(Pt 1):17-40.

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