Research Article
Imprints of Seizure Rate and Epilepsy Duration on Temporal Lobe Epilepsy Outcome
Pradeep Madhamanchi1,2, Sujatha Peela4, Kishore Madamanchi1, Sita Jayalakshmi3, Manas Panigrahi3, Haritha Ronanki2, Panchareddy Madhava Rao4, SPD Ponamgi5 and Prakash Babu Panithi1*
1Department of Biotechnology & Bioinformatics, University of Hyderabad, Gachibowli, Telangana, India
2Centre for Applied Sciences, Government Degree College (Men)-Srikakulam, Andhra Pradesh, India
3Department of Neurology, Krishna Institute of Medical Sciences, Secunderabad, India
4Department of Biotechnology, Dr. B. R. Ambedkar University-Srikakulam, Andhra Pradesh, India
5Department of Biotechnology, Andra University, Visakhapatnam, India
2Centre for Applied Sciences, Government Degree College (Men)-Srikakulam, Andhra Pradesh, India
3Department of Neurology, Krishna Institute of Medical Sciences, Secunderabad, India
4Department of Biotechnology, Dr. B. R. Ambedkar University-Srikakulam, Andhra Pradesh, India
5Department of Biotechnology, Andra University, Visakhapatnam, India
*Corresponding author: Prakash Babu Panithi, Department of Biotechnology & Bioinformatics, University of Hyderabad, Gachibowli, Telangana, India. E-mail Id: prakash@uohyd.ac.in
Article Information: Submission: 14/08/2023; Accepted: 19/09/2023; Published: 22/09/2023
Copyright: © 2023 Madhamanchi P, et al. 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
HS associated TLE is the common cause of PRE. Surgery is generally used to control seizures for these patients but most often seizure recurrence observed, reasons are not known. The aim of the study is to evaluate the effects of seizure rate and epilepsy duration on the long term post-surgical outcome
of AEDs and onset age matched 153 HS associated PR-TLE patients. All the patients invariantly associated with HS. Clinical data recorded during 2011 and 2023 obtained from outpatient at the department of Neurology, Krishna Institute of Medical Sciences, Secunderabad, India. EEG, MRI and FluoroJade
stain used to diagnose the TLE-HS in patients. All patients undergone medial temporal lobectomy for HS and assessed for seizure free outcome after first, third and fifth years using Engel’s and ILAE outcome system of classification. Overall 70.8% patients had very good post-surgical outcome (Engel’s-I & II or ILAE-I) in first year, it was reduced to 59.3% in third year and 47.6% in fifth year. The mean seizure rate was 6 per month (range 0.3 – 258 per month). Patients belong to daily and yearly seizure classes had good post-surgical outcome after first year of the surgery (p = 0.43), however mean drop of Engel’s-I or ILAE-I & II outcome after 5th year of the surgery was more in patients with weekly seizures (p = 0.63). Likely the mean epilepsy duration was 13.57
years (range 01 M – 42 years). Patients with less epilepsy duration had good post-surgical outcome than higher duration (p = 0.41). Besides unreliability of Engel’s-I or ILAE-I & II outcome during post-surgical period observed in patients with less epilepsy duration (p = 0.58) and less surgery age (p = 0.32). Through this study we observed that high seizure rate reduced the consistency of the seizure freeness after surgery. On the other side, higher duration of epilepsy and surgery ages lessen the immediate seizure freeness as well as consistency in outcome. However, we did not find any statistical significance (p< 0.05) while analyzing these data. This study suggests the valuation of Histology, Biochemical, and Molecular factors with long-term post-surgical outcome.
Keywords: Seizure Rate; Epilepsy Duration; Hippocampal Sclerosis; Temporal Lobe Epilepsy; Pharmaco Resistant Epilepsy; Engel’s Outcome; ILAE Outcome