Natural History of Temporal Lobe Epilepsy: Antecedents and Progression

Table 1

Summary of selected studies on TLE and relationship to IPE.

Study	𝑁	Criteria for diagnosis of TLE	IPE reported	Patients with TLE with positive history (%)
French [10]	67	Mesial temporal onset on depth EEG	Seizures in infancy/early childhood	54 [81]
		Nonlesional MRI	~ FS	52 [78]
		Seizure freedom since unilateral TLY, at least 2 years	~ Afebrile-Head	02
			Head trauma	10
			Birth trauma	02
			Other maternal factors	02
Tassi [11]	243	Surgery confined to temporal lobe, with histopathological data on neocortex and hippocampus	Febrile seizures [FS]
			FS in patients with HS	61 [25]
			FS in patients with HS only	15/34 [44]
			FS in patients with MCD	50/110 [45]
Harvey [12]	63 [new onset TLE-age of onset <15 years]	Agreement among 3 neurologists from clinical and investigational data; ictal EEG “gold standard”	Perinatal problems
			Head injury	24 [38]
			Bacterial meningitis	1
			Viral encephalitis	1
			FS	4
			Simple	1
			Complicated
			Respiratory arrest	6
			Hypertensive	7
			Encephalopathy	2
			Prolonged focal FS
			Infantile spasms	1
				1
				1
Sztriha [13]	30 [new onset TLE-age of onset <14years]	Agreement amongst 2 investigators based on clinical and investigational data; no alternative diagnosis likely	Antecedent illness	5 [16.6]
			Perinatal HIE	1
			Encephalitis	1
			Traumatic brain injury	2
			Complex FS	1
Ozkara [14]	165	Mesial TLE with HS on MRI; postoperative follow-up data for >1 year available	FS	116 [70.3]
			Risk factors	62 [37.6]
			[antecedents]	27
			Head trauma	21
			Birth asphyxia	11
			Neonatal infections	1
			Kernicterus	1
			Near drowning	1
			Heat stroke
Uijl et al. [15]	484	Epilepsy surgery patients who underwent TLY	FS	180 [37]
Jeong et al. [16]	227	mTLE; With HS on MRI and anterior temporal onset on ictal EEG; with normal MRI but clear mesial temporal onset on invasive electrode ictal recordings	FS	99 [43.6]
Rathore et al. [17]	124	Postoperative mTLE with histopathologically proven HS	Typical FS	85 [68.5]
			Atypical IPE	19
			Meningoencephalitis	10
			Febrile status	6
			Epilepticus
			Perinatal hypoxia	2
			Neonatal seizures	1
Berg et al. [8]	215 [Total patients analyzed =333]	Refractory partial epilepsy and HS on MRI, having undergone resective surgery for same	FS	95 [44.2]

FS: febrile seizures, mTLE: mesial temporal lobe sclerosis, HS: hippocampal sclerosis, HIE: hypoxic ischemic encephalopathy, FSE: febrile status epilepticus, TLY: temporal lobectomy, MCD: malformations of cortical development, and IPE: Initial precipitating event.