Is Temporal Lobe Epilepsy with childhood febrile seizures a distinctive entity? A comparative study

Objective: Pharmacoresistance continues to be a major challenge in Temporal Lobe Epilepsies (TLE). A key to overcome pharmacoresistance is to identify subgroups among the TLE and disclose their specific molecular pathways. This will facilitate a tailored pharmacological treatment and improve outcome. There is growing evidence in favor of the theory that TLE with childhood febrile seizures (TLE-FS) may represent one distinctive subgroup among the TLE.

Material and methods: We compared clinical features from 102 TLE-FS patients with 105 TLE patients without FS. We also conducted a logistic regression analysis to adjust for possible confounders caused by overrepresentation of patients with Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis (MTLE-HS) in the TLE-FS group.

Results: MTLE-HS was overrepresented in patients with TLE-FS (p=0.043). Age at epilepsy onset was lower in patients with TLE-FS (p<0.001). TLE-FS patients had a higher frequency of first grade family members with FS (p=0.003, adjusted for MTLE-HS: p=0.002). They were more frequently plagued with simple partial seizures (p=0.015, adjusted: p=0.038), and especially with vertiginous symptoms (p=0.004 adjusted: p=0.006). They also had the higher frequency of autonomic symptoms (p=0.003; adjusted: p=0.012), and more generalized tonic-clonic seizures (0.034; adjusted p=0.038).

Conclusion: We identified TLE-FS as a phenotype that can be delineated from other TLE. None of the characteristics are specific, but we disclosed a set of features also when adjusted for MTLE-HS.