ETIOLOGIC SPECTRUM OF SYMPTOMATIC LOCALIZATION RELATED EPILEPSIES - ASTUDY FROM SOUTH-INDIA

Putative etiology was studied in 991 patients with symptomatic localiz ation-related epilepsies seen in a university hospital in South India. They formed 39% of patients with various types of epilepsies and epil eptic syndromes seen during the study period. Seizure occurred in clos e temporal association with an acute central nervous system (CNS) insu lt in 53% of patients. Infections of CNS including single CT enhancing lesion (SCTEL) accounted for 77% of patients with acute symptomatic e pilepsy. Cerebrovascular diseases were the risk factors in 48% of pati ents with remote symptomatic epilepsy. Neurocysticercosis, SCTEL and s mall single cerebral calcific CT lesion (SSCCCTL) together accounted f or 40% of etiological factors and neurotuberculosis for 10%. Infection s of the central nervous system and SCTEL together were the putative r isk factors in 52% of patients aged less than or equal to 40 years. Ce rebrovascular diseases were the etiological factors in 64% of patients aged >40 years. Neurological handicaps from birth manifested by menta l retardation and/or cerebral palsy was the feature in 21% of children . The type of seizure was either simple partial or complex partial wit h or without secondary generalization in 76% of patients. The remainin g patients presented with either generalized tonic clonic seizures or unlocalized seizures. Localization to a single site of seizure origin proposed by the International League Against Epilepsy (ILAE) was possi ble in only 67.5% of patients. The most readily identifiable was motor cortex. In patients with unlocalized or generalized seizures the type of pathology was diffuse in 17% of patients and in 48.5% of patients, the lesion was located in the frontal brontoparietal lobe. (C) 1998 E lsevier Science B.V.