Criptogenic and symptomatic temporal epilepsies in adults

Five hundred thirty six patients with focal epilepsy, including 136 patients with temporal epilepsy (TE) aged 17–79 years were examined. In all patients specific therapy with antiepileptic drugs was initiated or corrected. The lack of pathological EEG changes was registered in 33 patients (24.3%), regional slowness in temporal zones was found in 22 (16.2%), focal epileptoform activity of the same localization – in 75 (55.1%), and diffuse epileptiform activity – in 6 (4.4%). On MRI, no changes in the brain were found in 50 patients (36.8%), non-epileptogenic changes (hydrocephaly, retrocerebellar cycts, etc.) were diagnosed in 17 (12.5%), moderately epileptogenic changes (post-stroke and posttraumatic cycts, foci of gliosis, etc.) in 42 (30.9%), and highly epileptogenic in 14 (10.3%), including hippocampal sclerosis in 8 (5.9%). The vast majority of adult TE cases were found to manifest with combination of secondarily generalized and focal (partial) seizures, the latter being predominantly automotor (32.3%) and dialeptic (27.9%). Medication remission among the patients under study was achieved in only 28.2% of cases; this confirms the opinion that TE represents not only the most frequent form of focal epilepsy in adults, but also great challenge for cure.