Open Access
CC BY-NC-ND 4.0 · International Journal of Epilepsy 2023; 09(01/02): A1-A40
DOI: 10.1055/s-0044-1791428
E-Poster Abstracts

Coexistence of Genetic Generalized Epilepsy and Temporal Lobe Epilepsy

Authors

  • Kheta Ram Sharma

    1   All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

  • Naman Agarwal

    1   All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

  • Smahita Panda

    1   All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

  • Sarbesh Tiwari

    1   All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Introduction: Incidence of coexistent genetic generalized epilepsy (GGE) in patients with temporal lobe epilepsy (TLE) is uncertain and poses a challenge, especially if seizures are resistant to antiseizure medications (ASMs) and surgical treatment is being considered. A minority of patients with drug-resistant TLE, who fail to achieve seizure freedom following anterior temporal lobectomy, may have other coexisting epilepsy syndromes. Failure to identify such coexistence can affect postoperative long-term seizure outcome and choice of ASM.

Case Report: A 11-year-old right-handed girl, born of nonconsanguineous marriage with normal birth and developmental history was admitted for evaluation of daily drug resistant epilepsy (DRE) on 3 ASMs. She had febrile seizures in childhood and multiple episodes of focal motor impaired aware to bilateral tonic-clonic seizure since age of 6 to 7 months. There was family history of seizures in her father and paternal uncle, grandmother and cousin. MRI brain suggested right mesial temporal sclerosis with associated amygdala dysplasia. However, electroencephalogram showed generalized spike wave discharges consistent with GGE along with independent right temporal spike wave discharges. Asymmetrical hypometabolism in right mesial temporal lobe was noted on PET scan.

Discussion: Occurrence of clinical and EEG features of GGE in patients with focal DRE has rarely been documented. At our center, of 123 patients who underwent detailed evaluation for DRE, we found one case of coexisting GGE and drug resistant TLE (0.81%). This is comparable to a series that looked into the coexistence of GGE with any other form of focal epilepsy, and not TLE in particular. In another series of 350 consecutive patients who underwent resective surgery for drug-resistant TLE, two had associated GGE. The further line of treatment for best possible results in these situations will be discussed.

Conclusion: This case study highlights the rare association of GGE with TLE and discusses the dilemmas in decision making process for optimal patient management.



Publication History

Article published online:
12 September 2024

© 2023. Indian Epilepsy Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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