Abstracts

Rationale: Somatosensory auras are reported infrequently in temporal lobe epilepsy and their significance is largely unknown. The purpose of this study is to look at the prevalence, the characteristics and prognostic value of somatosensory auras in refractory temporal lobe epilepsy in patients who have undergone surgical intervention for a better control of their seizures. Methods: We retrospectively reviewed patients who have undergone temporal lobectomy at the Cleveland clinic Epilepsy Center between 2008 and 2010 to treat pharmacoresistant epilepsy. A minimum postoperative follow-up of 6 months was required. Results: 159 patients fulfilled the study criteria, including 46 patients who had an invasive evaluation. 11 (6.9%) patients had somatosensory aura (SSA). 7 had bilateral and 4 had unilateral SSA. One patient had an associated psychic aura, and another had abdominal aura. Eight underwent left TL resection and 3 underwent right TL resection. Four had invasive evaluation prior to resection. Our results indicate that patients with SSA are more likely to have a non lesional MRI compared to patient without SSA (p= 0.04). There was no significant difference in pathology. In this limited sample, there was a non-statistically significant trend towards more seizure recurrence in patients with SSA (73% recurrence rate in SSA group compared to 52% otherwise;p=0.14). The likelihood of longterm remission though, as defined by an Engel score of 1 at last follow-upwas similar in both groups (p=0.98). Conclusions: Somatosensory auras in temporal lobe epilepsy may increase the risk of any breakthrough seizure after surgery, but do not alter longterm remission rates. Their presence may represent a wider epileptogenic zone.