Clinic Analysis Of 121 Cases Of Temporal Lobe Epilepsy

Objective:To perform a retrospective analysis for the clinical symptoms,imaging features,electroencephalogram characteristics and the treatment efficacy of 121 cases of temporal lobe epilepsy(TLE)patients,providing some reference for clinical diagnosis and treatments of TLE.Methods:We chose 121 cases of TLE patients in outpatient and hospital departments from September 2015 to February 2017 in Kunming Sanbo Brain Hospital.To collect the clinical data including birth history,past medical history,family history of epilepsy,age of onset,course of diseases,and the characteristics of semiology.Then we should record the the Magnetic Resonance Imaging(MRI)and Video electroencephalogram(VEEG)results.Surgery patients need to record the operation ways and the histopathological results.All patients were followed up for six months or more with the efficacy.Finally,We conducted a detailed systematic analysis for the clinical symptoms,the results of the MRI and the EEG,the prognosis of curative effect of the antiepileptic drugs(AEDs)and surgical treatment.Results:Of the 121 cases patients with TLE,64 cases were men and 57 cases were women.61 cases(50.41%)of patients were aged less than 15 years and 97 cases(80.17%)less than 30 years.42 patients(34.71%)had past medical history of febrile convulsion,head trauma,and encephalitis.64 cases(52.89%)patients had different aura,including fear,dizziness and vertigo,palpitations,hallucinations,deja vu,a rising epigastric sensation and so on.There were 62(51.24%)cases of patients with only one form of epileptic seizures,the majority of which were complex partial seizure(CPS)and generalized tonic clonic seizure(GTCS).The remaining 59 cases(48.76%)patients existed two forms of epileptic seizures.The positive incidence of MRI was 93.39%,and the main abnormalities included hippocampal sclerosis,cavernous hemangioma,softening lesion and the tumors in temporal lobe.91.74%of all patients have been checked out the abnormalities of epileptic discharge by VEEG,with 72 cases in a seizure phase and 39 cases(32.23%)in interictal period.101 cases of TLE patients had conduct standardized AEDs treatment.The total drug curative rate was 55.45%,including 38.61%of monotherapy,13.86%of two kinds AEDs and2.97%of three kinds AEDs curative rate.Surgical treatment was performed in 51 patients and 47 cases followed by six months had a significant curative efficiency.The total surgical curative rate was about 92.16%(Engle ?-?were noted in the 47 cases of patients.).Conclusions:1.Most of the onset age of TLE patients are childhood and adolescence.Some patients are related to past medical histories of febrile convulsion,head trauma,and encephalitis.Most of the patients before the seizure has all kinds of aura,including fear,dizziness and vertigo,palpitations,hallucinations,dej a vu,a rising epigastric sensation and so on.The majority of the forms of epileptic seizures are complex partial seizure(CPS)and generalized tonic-clonic seizure(GTCS).2.MRI examination and VEEG monitoring have great value of the diagnosis of TLE.They provide an important basis for the further treatment of TLE patients.3.AEDs are the major treatment of TLE patients,and such as oxcarbazepine(OXA),carbamazepine(CBZ)and levetiracetam(LEV)had a better effect on TLE patients.4.Surgical treatment is a safe and effective method for TLE patients.Surgical evaluation should be performed on refractory epilepsy patients.5.Mastering the clinical symptoms,MRI features and EEG characteristics,selecting appropriate AEDs and conducting surgical evaluation is the key to the treatment of TLE.