In order to more precisely define temporomedial epilepsy with hippocampal sclerosis, we evaluated 20 patients with magnetic resonance imaging findings of it: 1. Abnormal high signal of the hippocampus on T2 and Flair, 2. Hippocampal atrophy and 3. Structural deformity in hippocampus. 6 patients (55%) had history of febrile seizures during early chilhood or infancy. 4 patients (36%) had head trauma and 1 patient (9%) had neonatal hypoxia. The mean age of seizure onset was 18 years. All patients had complex partial seizures at onset.15 patients (75%) had auras, with abnormal abdominal visceral sensation being the most common type (40%). 11 patients with identified risk factors had an interval between the presumed cerebral insult and the development of habitual seizures, with a mean seizure free interval of 11 years. All patients had oroalimentary automatisms, and 14 patients (70%) also had other automatisms. 9 patients (45%) had lateralizing signs, 6 patients had contralateral version of the head and eyes and 3 patients had dystonic posturing of the contralateral upper extremity. 15 patients (75%) had an abnormal electroencephalogram. 13 patients (87%) showed paroxysmal abnormalities that were localized in the anterior temporal region, over the side of the hippocampal sclerosis in 12 patients and over one temporal lobe in 1 patient with bilateral hippocampal sclerosis with paroxysmal activity. . 2 patients (13%) had interictal bilateral temporal slowing, these patients had bilateral hippocampal sclerosis.
Temporal Lobe Epilepsy
Estudio de 20 pacientes con epilepsia del lóbulo temporal medial con esclerosis del hipocampo.
Tipificación del Trastorno Afectivo en Pacientes con Epilepsia del Lóbulo Temporal.
Introduction: Affective disorders in people with epilepsy seem to be different from patients with primary mood disorders.
Objective: to determine the clinical characteristics that typifies depression in patients with temporal Lobe Epilepsy.
Patients and methods: Forty patients with Temporal Lobe Epilepsy and depression were enrolled in the study. Thirty one patients with primary depressive disorder were recruited as control group. Depression was clinically evaluated in both groups. The discriminate analysis was used to determine the main clinical features of depression in patients with epilepsy. The differentiation between groups in total scores of Mood disorders through the International Psychiatry Interview was used to determine the atypical sign of depressive symptoms in patients with epilepsy. Logistic regression was utilized to analyze the possible relationship between neurobiological functioning and depressive symptoms in patients with epilepsy. Results: Sixty two percent of patients had a mood disorder not classified in CIE-10 and DSM-IV. Perictal anhedonia associated with insomnia, guilty thoughts, psychomotor slowness, inattention, restlessness, irritability, faintness became the clinical profiles of depression in patients with epilepsy. Age of onset of epilepsy, family history of psychiatric disorders, number of seizures per month, left temporal Lobe Epilepsy, and bilateral hippocampal atrophy were the most important determinants of mood disorders in our study.
Conclusion: Brief perictal depressive symptoms associated with dysphoria, anxiety and phobias, typify the clinical profile of depressive syndrome in patients with Temporal Lobe Epilepsy.
