Association between Clinical Features and MRI Findings in Patients with Temporal Lobe Epilepsy

Temporal lobe seizures are commonly called focal seizures with impaired awareness. Temporal lobe epilepsy (TLE) is known to be the most common cause of partial seizures. However, there is a not much known about the correlation of clinical features of temporal lobe epilepsy with specific imaging findings on MRI.

In this single-centered observational study, researchers evaluated the association between the semiology of temporal lobe epilepsy with specific etiological findings as identified on MRI. This was a study in which consecutive patients presenting with clinical features diagnostic of temporal lobe epilepsy underwent a brain MRI.

A total of 90 patients were included with the mean age of the study population being 29 years. Females comprised 45% of the total sample. Mesial temporal sclerosis (MTS) was the most common imaging finding in about 60% of patients. Four out of five patients had aura whereas 70% had automatisms.

The findings highlighted that the presence of aura in temporal lobe epilepsy patients was significantly associated with Mesial temporal sclerosis on MRI. The presence of automatism and history of childhood febrile seizure did not have a significant association with any specific etiological findings on MRI. The presence of dual pathology on MRI was associated with drug-refractory epilepsy.

The researchers concluded presence of aura and drug-refractory epilepsy both actually point towards the presence of Mesial temporal sclerosis. Dual pathology, on MRI, in temporal lobe epilepsy patients may be a risk factor for drug-refractory epilepsy.

Reference:

Ojha V, Mani A, Basu D, et al. Association between Clinical Features and Magnetic Resonance Imaging Findings in Patients with Temporal Lobe Epilepsy. J Assoc Physicians India 2022;70(11):13–17.