Abstracts

Rationale: The study aims to determine the prevalence of Temporal Lobe Epilepsy (TLE) in a tertiary-care hospital in Pakistan. The study also highlights patient subset with Mesial Temporal Sclerosis (MTS) confirmed through MRI as future surgical candidates. Methods: A retrospective study in a hospital-setting with an established specialized epilepsy clinic. A detailed questionnaire was filled describing seizure semiology and relevant investigations. 619 visiting patients were registered in the clinic. All files were reviewed. Seizure classification was documented in the files by two American Board Certified epileptologists. Patient with non-epileptic events were excluded. All MRI's were reviewed and MTS was identified using 2mm coronal slices. Results: 469 patients were diagnosed with epilepsy. These included 247(53.6%) males and 213(46.3%) females. Out of 186 patients with complex partial seizures with or without secondary generalization, 84(45%) had TLE. EEG reports were available for 78/84 patients, out of which 66(89%) showed temporal discharges. MTS was confirmed in 27%. Good seizure control was achieved in 21(25%) while 24(28%) were refractory to drug therapy. Conclusions: TLE is a prevalent form of focal onset seizures with or without secondary generalization in Pakistan, a quarter of whom remain refractory to drug therapy and a third have MTS. The high number of TLE and MTS patients at our clinic emphasizes the need for comprehensive epilepsy surgical programs in Pakistan. Our numbers are in keeping with the published literature.