2018 Volume 35 Issue 3 Pages 715-721
Previous studies have estimated that one medial temporal lobe epilepsy (MTLE) patient per 100,000 population is a good candidate for surgery, but these patients are easily overlooked if the attendant physician and/or the patient's guardian do not recognize the specific seizure symptoms.
Over a period of 9 years in the western Iburi district of Hokkaido prefecture (population 205,000), we have encountered three surgical cases of MTLE patients who have become seizure free. All three patients had been diagnosed initially as having drug-resistant unclassifiable symptomatic localization-related epilepsy.
All three patients were eventually diagnosed as having MTLE because of an awareness of the characteristic clinical symptoms of MTLE and results of neuroimaging and electrophysiological studies; however, it took 5-11 years (mean 7.3 years) from the onset of the epilepsy attacks until a diagnosis of MTLE was made and 6-11 years (mean 8.3 years) until the surgeries were performed.
Because the initial seizures in MTLE generally occur in patients around 5-10 years of age, pediatricians are the attendant physicians for the initial diagnosis and treatment. Thus, it is important that general pediatricians are aware of the clinical features of MTLE to ensure a favorable prognosis for their patients.
