Temporal Lobe Epilepsy and Obesity in Adults

Background: Epilepsy is a common, chronic, and disabling neurologic state. Medial temporal lobe epilepsy (TLE) is the commonest, and best-defined, form of symptomatic localization-related epilepsy. Obesity-induced mitochondrial dysfunction and oxidative stress are thought to participate in the initiation and progression of epilepsy. Obesity is a potentially preventable predisposing factor for drug resistant epilepsy (DRE). Objective: the aim of this study was to investigate the association of TLE with obesity and the effect of obesity on seizure control. Methods: This case control study was carried out on 50 patients with TLE and was divided into two groups, group A included 25 obese TLE patients and group B included 25 non-obese TLE patients. The control group included also, 25 age and sex matched healthy subjects. For all subjects, body weight (BW), height, body mass index (BMI), waist and hip circumference was measured. The laboratory investigations included lipid Profile, serum adiponectin level, fasting glucose level, and fasting insulin level. Results: Frequency of seizures per month was more among obese TLE cases than non-obese TLE cases. There was statistically significant higher mean BW, BMI, waist, and hip circumference among obese TLE cases than non-obese TLE cases and control group. There was a statistically significant higher median fasting blood sugar (FBS) level, serum cholesterol, serum triglycerides, very low density lipoprotein (VLDL), fasting insulin level with lower serum HDL among obese TLE cases than NON-obese TLE and control group. A statistically significant positive correlation between Frequency of seizures per month and FBS level, Serum TGS, VLDL, fasting insulin level, weight, body mass index, waist & hip circumference, presence of fatty liver by ultrasound and body mass index. Conclusion: our study revealed the close relationship between obesity and TLE. The risk of DRE was higher among obese TLE than non-obese patients. Physical exercise, diet, lifestyle counseling, and the selective use of Anti-Seizure Medications to maintain normal weight can provide potential protection against DRE.