Absence of simple partial seizure in temporal lobe epilepsy: its diagnostic and prognostic significance

The diagnostic and prognostic significance of the absence of simple partial seizures (SPS) immediately preceding complex partial seizures (CPS) was ex amined in patients with temporal lobe epilepsy. The status of self-reported SPS in 193 patients with temporal lobe epilepsy who had surgical therapy m ore than 2 years ago was reviewed. Before surgery, 37 patients never experi enced SPS before CPS (Group A), 156 patients either always or occasionally had SPS before CPS (Group B). The frequency of mesial temporal sclerosis (M TS) was lower and the age at onset of epilepsy was higher in Group A. The s eizure focus was in the language-dominant temporal lobe in 73% of the cases in Group A, compared with 40% in Group B. The surgical outcome did not dif fer between the two groups. The findings suggest that temporal lobe seizure s without preceding SPS tend to originate in the language-dominant temporal lobe that contains a pathologic etiology other than MTS, especially in the lateral temporal lobe. The surgical outcome in patients without SPS is sim ilar to that in patients with SPS. (C) 2000 Elsevier Science B.V. All right s reserved.