Frequency of Temporal Lobe Lesions in People with Epilepsy. A Single Center Study

Background. Temporal lobe epilepsy is characterized by seizures originating from the temporal lobe, common causes which include mesial temporal lobe sclerosis and tumors. In a community with high rates of brain injury and risk factors for epilepsy, it is expected that the rate of mesial temporal lobe sclerosis will be high. The aim of this study is to describe the pattern of brain MRI temporal lobe lesions in people living with epilepsy in Enugu Nigeria. Methods. This was a retrospective descriptive study carried out at Memfys Hospital Enugu. MRI reports included in the study were between December 2019 and June 2022. Results. Out of the 875 brain MRIs of people living with epilepsy, 120 (13.7%) had lesions localized on the temporal lobe. There was no significant difference in the age distribution of the patients. Mesial temporal sclerosis was diagnosed in 33 (27.5%) out of the 120 with temporal lobe lesions. Other common structural findings were atrophy 21(17.5%) and tumors 14 (11.7%). Mesial temporal lobe sclerosis and atrophy decreased with age. Other parts of the brain involved were parietal lobe (18.3%) and frontal lobe (15.8%). Conclusion. About 13.7% of epilepsy patients had temporal lobe lesions on brain MRI and mesial temporal sclerosis constituted 27.5% of these lesions. Other common findings were temporal lobe atrophy 17.5% and tumors 11.7%. Studies that correlate clinical and structural brain MRI findings will better elucidate the burden of temporal lobe epilepsy among epilepsy patients in Nigeria.