Table of Contents
Epilepsy Research and Treatment
Volume 2012 (2012), Article ID 195073, 8 pages
http://dx.doi.org/10.1155/2012/195073
Review Article

Natural History of Temporal Lobe Epilepsy: Antecedents and Progression

1Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India
2Departments of Pediatrics and Clinical Neurosciences, Schulich School of Medicine and Dentistry, Children's Hospital, London Health Sciences Centre, London, ON, Canada N6A 5W9

Received 21 September 2011; Revised 20 December 2011; Accepted 29 December 2011

Academic Editor: Seyed M. Mirsattari

Copyright © 2012 Garima Shukla and Asuri N. Prasad. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Temporal lobe epilepsy represents the largest group of patients with treatment resistant/medically intractable epilepsy undergoing epilepsy surgery. The underpinnings of common forms of TLE in many instances begin in early life with the occurrence of an initial precipitating event. The first epileptic seizure often occurs after a variable latency period following this event. The precise natural history and progression following the first seizure to the development of TLE, its subsequent resolution through spontaneous remission or the development of treatment resistant epilepsy remain poorly understood. Our present understanding of the role played by these initial events, the subsequent latency to development of temporal lobe epilepsy, and the emergence of treatment resistance remains incomplete. A critical analysis of published data suggest that TLE is a heterogeneous condition, where the age of onset, presence or absence of a lesion on neuroimaging, the initial precipitating event, association with febrile seizures, febrile status epilepticus, and neurotropic viral infections influence the natural history and outcome. The pathways and processes through which these variables coalesce into a framework will provide the basis for an understanding of the natural history of TLE. The questions raised need to be addressed in future prospective and longitudinal observational studies.