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Analysis of seizure frequency over the years in patients with Mesial Temporal Lobe Epilepsy associated with Hippocampal Sclerosis

Grant number: 22/09331-9
Support Opportunities:Scholarships in Brazil - Doctorate (Direct)
Effective date (Start): August 01, 2022
Effective date (End): June 12, 2023
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal Investigator:Fernando Cendes
Grantee:Aline de Fátima Dias
Host Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil
Associated research grant:13/07559-3 - BRAINN - The Brazilian Institute of Neuroscience and Neurotechnology, AP.CEPID

Abstract

Mesial Temporal Lobe Epilepsy (mTLE) is the most common focal epilepsy in adults and has Hippocampal Sclerosis as its main cause. Studies that assess the natural history of mTLE associated with Hippocampal Sclerosis define it as an epileptic syndrome with specific characteristics, including: the history of an initial precipitating event followed by a silent period (between the initial event and the onset of refractory epileptic seizures) and progressive evolution of hippocampal atrophy on neuroimaging. The treatment of mTLS involves the use of anti-seizure drugs which are associated with several side effects. About 75% of patients will have pharmacoresistance. Currently, there are still no studies that evaluate the behavior of this pathology after several years and there are no studies that evaluate the frequency of seizures in a long period of follow-up, especially in relation to the elderly population, as well as the frequency, dosage and combination of anti-seizure drugs that are used over years of follow-up. Objective: To evaluate the frequency of epileptic seizures over the years in patients with Mesial Temporal Lobe Epilepsy associated with Hippocampal Sclerosis, and to evaluate the relationship between the use of anti-seizure drugs over the years and their effects on seizure control in patients with mTLE associated with Hippocampal Sclerosis. Materials and methods: A retrospective longitudinal study will be carried out including patients followed up at the Neurology outpatient clinic of the Hospital de Clínicas, UNICAMP, and who present a diagnosis of Mesial Temporal Lobe Epilepsy according to the criteria of the International League Against Epilepsy (ILAE). Hippocampal Sclerosis will be evidenced-based on the presence of hippocampal volumetric reduction and hippocampal hyperintense signal on T2-weighted and FLAIR MRI. Data related to the frequency and type of seizures (focal perceptive, focal perceptive and secondarily generalized) will be collected from medical records over the years of follow-up in the service. Data on which anti-seizure medications and their dosages over the years will be evaluated. All data will be evaluated in relation to the time of diagnosis of Epilepsy and the age of the patient. (AU)

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