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Comparative analysis of thalamic and hippocampal volume in patients with mesial temporal lobe epilepsy responsive or not to drug therapy

OBJECTIVE: To investigate the variation of thalamic and hippocampal volume in patients with mesial temporal lobe epilepsy (MTLE) refractory or responsive to drug therapy. METHODS: We analyzed 26 patients with MTLE responsive to drug therapy, 25 refractory and 23 controls through the manual delineation of anatomic limits of the hippocampus and thalamus, in sequential sections of MR images. The DISPLAY software was used. Statistical analysis was performed using the program Systat 9. RESULTS: There were statistically significant differences between controls and patients groups for thalamic volumes ipsilateral to epileptogenic focus (p=0.00004). There was no statistical difference between the 3 groups for the volumes of the thalamus contralateral to the epileptogenic focus. There was significant correlation between ipsilateral hippocampus and thalamus ipsilateral to epileptogenic focus (r=0.35, p=0.004). The older the age, the lower the ipsilateral thalamic volume (p=0.002 and r=-0.37). CONCLUSION: The data showed that hippocampal atrophy is also present in patients with TLE and good seizure control. The atrophy of thalamus was correlated with the age of patients, which may also indicate that other factors besides the seizure frequency influences the degree of damage of this structure.

temporal lobe epilepsy; magnetic resonance imaging; volumetry


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