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Seizures in family members of patients with hippocampal sclerosis

From the Epilepsy Research Institute (Drs. Briellmann and Berkovic, and Y. Torn–Broers) and Brain Research Institute (Drs. Briellmann, Jackson, and Berkovic), Austin and Repatriation Medical Center, University of Melbourne, Australia.

Address correspondence and reprint requests to Prof. Samuel F. Berkovic, Epilepsy Research Institute, Neurosciences Building, Repatriation Campus, Heidelberg West, Victoria 3081, Australia; e-mail: s.berkovic{at}unimelb.edu.au

Objective:— To characterize seizures in family members of patients with refractory temporal lobe epilepsy (TLE) and hippocampal sclerosis (HS).

Methods:— The authors systematically investigated family history (FH) of seizures in 66 probands with histologically proven HS, and in 51 control subjects. A positive FH was defined as at least one first-to-third–degree relative being affected. The odds ratio (OR) to be affected with seizures was calculated for siblings, parents, and aunts/uncles.

Results:— An FH of seizures was found in 58% of patients, and in 24% of control subjects (p = 0.02). A variety of seizure types were found. Siblings of patients were more likely to be affected than siblings of control subjects (OR 11.5; 95% CI = 1.5 to 86.9 p = 0.003), with febrile convulsions occurring in 5.8% of the siblings of patients. The OR of being affected was 5.7 for parents of patients, and 1.9 for aunts/uncles of patients (p = NS).

Conclusion:— FH of seizures, particularly febrile convulsions, are a risk factor for TLE with HS. These data suggest that a variety of genes contributing to epilepsy phenotypes in relatives may be involved in the pathogenesis of HS.

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