Please use this identifier to cite or link to this item:
Title: Familial mesial temporal lobe epilepsy and the borderland of déjà vu
Austin Authors: Perucca, Piero ;Crompton, Douglas E;Bellows, Susannah T;McIntosh, Anne M ;Kalincik, Tomas;Newton, Mark R;Vajda, Frank JE;Scheffer, Ingrid E ;Kwan, Patrick;O'Brien, Terence J;Tan, K Meng;Berkovic, Samuel F 
Affiliation: Departments of Medicine and Neurology, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia
Epilepsy Research Centre, Department of Medicine, Austin Health, University of Melbourne, Heidelberg, Victoria, Australia
Neurology Department, Northern Health, Melbourne, Victoria, Australia
Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
Departments of Paediatrics and Neurology, Royal Children's Hospital, University of Melbourne, Melbourne, Victoria, Australia
Issue Date: Aug-2017
Date: 2017-07-06
Publication information: Annals of Neurology 2017; 82(2): 166-176
Abstract: OBJECTIVE: The cause of mesial temporal lobe epilepsy (MTLE) is often unknown. We ascertained to what extent newly diagnosed nonlesional MTLE actually represents familial MTLE (FMTLE). METHODS: We identified all consecutive patients presenting to the Austin Health First Seizure Clinic with MTLE and normal magnetic resonance imaging (MRI) or MRI evidence of hippocampal sclerosis over a 10-year period. Patients' first-degree relatives and pairwise age- and sex-matched controls underwent a comprehensive epilepsy interview. Each interview transcript was reviewed independently by 2 epileptologists, blinded to relative or control status. Reviewers classified each subject as follows: epilepsy, specifying if MTLE; manifestations suspicious for epilepsy; or unaffected. Physiological déjà vu was noted. RESULTS: Forty-four patients were included. At the Clinic, MTLE had been recognized to be familial in 2 patients only. Among 242 subjects interviewed, MTLE was diagnosed in 9 of 121 relatives versus 0 of 121 controls (p = 0.008). All affected relatives had seizures with intense déjà vu and accompanying features; 6 relatives had not been previously diagnosed. Déjà vu experiences that were suspicious, but not diagnostic, of MTLE occurred in 6 additional relatives versus none of the controls (p = 0.04). Physiological déjà vu was common, and did not differ significantly between relatives and controls. After completing the relatives' interviews, FMTLE was diagnosed in 8 of 44 patients (18.2%). INTERPRETATION: FMTLE accounts for almost one-fifth of newly diagnosed nonlesional MTLE, and it is largely unrecognized without direct questioning of relatives. Relatives of patients with MTLE may experience déjà vu phenomena that clinically lie in the "borderland" between epileptic seizures and physiological déjà vu.
DOI: 10.1002/ana.24984
ORCID: 0000-0003-4580-841X
Journal: Annals of Neurology
PubMed URL:
Type: Journal Article
Appears in Collections:Journal articles

Show full item record

Page view(s)

checked on Dec 5, 2023

Google ScholarTM


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.