Suspected new‐onset autoimmune temporal lobe epilepsy with amygdala enlargement

Summary ObjectiveRecent reports define temporal lobe epilepsy with amygdala enlargement (TLE‐AE) as a distinct electroclinical syndrome comparable to TLE with hippocampal sclerosis. In this retrospective observational study, we present the largest consecutive series of patients with new‐onset TLE‐AE to date and describe clinical characteristics and seizure outcome, and we aim to explore underlying autoimmune mechanisms within this syndrome. MethodsWe reviewed all consecutive patients between 2004 and 2014 at our tertiary epilepsy center at the University of Bonn, Germany, with new‐onset (<5 years) TLE‐AE, negative serum antibody (ab) test results, and with available follow‐up data for at least 12 months. ResultsWe identified 40 patients (23 male) with TLE‐AE with a median age at epilepsy onset of 51 years (range 10–73) and a median disease duration of 11 months (range 0.5–55) at first presentation. At follow‐up, 50% of the entire cohort achieved seizure freedom. Of interest, patients with remittent features of AE at follow‐up (N = 24) had a superior outcome compared to those with stable magnetic resonance imaging (MRI) features of AE (N = 16): 17 (71%) of 24 were seizure‐free for at least 6 months compared to 3 (19%) of 16, respectively (p = 0.003). MRI volumetry confirmed significantly enlarged amygdalae in TLE‐AE in relation to healthy controls, and additionally showed significantly greater volume reductions in patients with remittent AE compare...
Source: Epilepsia - Category: Neurology Authors: Tags: Full ‐Length Original Research Source Type: research