A Clinical Study On Temporal Lobe Epilepsy

Objective:Temporal lobe epilepsy is the main types of refractory epilepsy. Through analysis of the clinical features of patients with temporal lobe epilepsy, electroencephalographic characteristics, characteristics of head magnetic resonance imaging and analysis of antiepileptic drugs efficiency provide the basis for the clinical diagnosis and treatment of TLE.Subjects and Methods:73cases of temporal lobe epilepsy admitted in Neurology Department of the first affiliated hospital of Kunming Medical University from September2010to December2011were included, with case history inquired in detail. Their EEG and head MRI results were analyzed carefully. Their antiepileptic drugs efficacy, prognosis and side-effect were observed. And the above information is for statistical analysis.Results:39cases of medial temporal lobe epilepsy,14cases of lateral temporal lobe epilepsy, and20cases of patients can not be distinguished between the medial temporal lobe epilepsy and lateral temporal lobe epilepsy from overall73cases;56cases of symptomatic temporal lobe epilepsy,17cases of idiopathic and cryptogenic temporal lobe epilepsy. The clinical, EEG, head MRI of the medial temporal lobe epilepsy and lateral temporal lobe epilepsy may have a characteristic performance. The onset age of the medial temporal lobe epilepsy is relatively earlier; most patients have the cause of hippocampal lesions and the clinical seizures manifested mainly as visceral paraesthesia, fear, resting gaze, automatism, and More likely to develop into tonic-clonic seizures.EEG epileptiform discharges part mostly in the anterior temporal, epileptiform waves mainly dominated by sharp waves and spikes and temporal slow wave increased, alpha-wave activity reduced in the background and paroxysmal0,5wave, head MRI usually has the performance of the medial temporal lobe abnormalities and hippocampal sclerosis atrophy; It can easily develop into intractable temporal lobe epilepsy. The onset age of lateral temporal lobe epilepsy is usually older, and it is mainly related to secondary causes, such as head trauma, cerebral vascular diseases. Clinical seizures manifested mainly as hallucinations, hemifacial spasm, and language barrier. EEG epileptiform discharges part mostly in temporal lobe in posterior temporal area, without slow wave increased, a background activity reduction of alpha-wave and paroxysmal θ,δ wave, head MRI may have lateral temporal lobe abnormalities, such as temporal lobe encephalomalacia, gliosis, vascular malformation. The patients with temporal lobe epilepsy age of onset are smaller, the course is longer, and then it is heavier harm to the cognition function. After choosing the correct and reasonable antiepileptic drugs,91.7%of patients with temporal lobe epilepsy attack decreased by50%in six months,68.4%of patients' seizures can be completely controlled within six months. A new generation of antiepileptic drugs, such as lamotrigine and levetiracetam has a good effect on temporal lobe epilepsy.Conclusions:1,Temporal lobe epilepsy is the most common types of refractory epilepsy. As the most common refractory epilepsy of temporal lobe epilepsy, it has a characteristic feature of clinical seizures, characteristics of EEG and performance of imaging. The clinical seizures of medial temporal lobe epilepsy manifested mainly as visceral paraesthesia, fear, resting gaze, automatism;EEG epileptiform discharges part mostly in the anterior temporal, and MRI often reveals mesial temporal lobe abnormalities and Hippocampal sclerosis atrophy.The clinical seizures of lateral temporal lobe epilepsy manifested mainly as hallucinations, hemifacial spasm, and language barrier. EEG epileptiform discharges part mostly in temporal lobe in posterior temporal area, MRI often manifests temporal lobe lateral abnormal.2,A new generation of antiepileptic drugs, such as lamotrigine and levetiracetam have a good effect on temporal lobe epilepsy.3,Correct grasp of the characteristics of the clinical onset of temporal lobe epilepsies features, head MRI findings and reasonable use of antiepileptic drugs is the key to successful treatment of temporal lobe epilepsy.