Prevalence of mesial temporal sclerosis in patients with epilepsy who underwent magnetic resonance imaging in Gondar university hospital, North-West Ethiopia 2020

Background- Mesial temporal lobe sclerosis is commonly associated with intractable temporal lobe epilepsy and is seen in about 60% to 80% of cases. This study is aimed at determining the prevalence of mesial temporal sclerosis on MRI among all epilepsy patients. Methods- Hospital based retrospective cross-sectional study in adult patients referred for MRI of the brain from January 2019 - September 2020 were conducted. The study is carried out at the University of Gondar Referral Hospital with a 1.5T Philips MRI machine, in Gondar town located 741 k.m. northwest of Addis Ababa. Results - A total of 77 patients were included, out of which 61 had generalized tonic clonic epilepsy, 7 had focal impaired awareness seizures, 6 had focal to bilateral tonic clonic and 2 had focal aware. Features of mesial temporal sclerosis were identified in 8 of 77 (10.4 %) of the cases, all of them had generalized tonic-clonic epilepsy & none of our participants with mesial temporal sclerosis had focal impaired awareness seizures. Mesial temporal sclerosis in our study is found to equally involve the right (50 %) and left (50 %) sides and none of our patients have bilateral involvement, and the most common findings are hippocampal atrophy in 6 out of 8 (75 %) of the cases and increased hippocampal signal intensity in 5 of 8 (62.5 %). Conclusion - The prevalence of mesial temporal sclerosis in patients with epilepsy is found to be less than what is documented in most literatures.