Objective To explore the effect of combined frontal lobe motor symptoms on the severity and prognosis of drug therapy in patients with temporal lobe epilepsy (TLE).

Methods From April 2018 to December 2019, 151 patients with TLE were collected in the Department of Neurology, Zhongshan Hospital, Fudan University. All the patients received 16-hour continuous long-range video EEG monitoring. Patients were divided into combined frontal lobe motor symptoms group (TLE/F+, n=42) and non-combined frontal lobe motor symptoms group (TLE/F-, n=109). Epileptic symptoms, VA-2 epileptic severity score and MMSE score were compared between the two groups. Multivariate regression analysis was used to find risk factors of epilepsy severity. Patients were followed up for one year, and the incidence of drug-resistant epilepsy (DRE) was compared between the two groups.

Results The incidence of TLE with frontal lobe motor symptoms was 27.81%. Compared with TLE/F- group, patients in TLE/F+ group had higher seizure frequency (P=0.002), higher VA-2 score (P=0.002), higher antiepileptic drug use rate (83.33% vs 64.22%, P=0.029) and higher multi-drug combination rate (38.10% vs 22.02%, P=0.036). Multivariate analysis showed that the contralateral deflection of the head and eyes was a common risk factor for the increased attack frequency (OR=8.246, P=0.004) and increased VA-2 score (β=0.277, P < 0.001), and excessive movement (β=0.343, P=0.003) was the risk factor of increased VA-2 score. After one year's follow-up, patients in TLE/F+ group had a higher rate of DRE than those in TLE/F- group (50.0% vs 15.0%, P < 0.001).

Conclusion TLE combined with frontal lobe motor symptoms is related to the increased seizure severity, and it is also a negative factor for the prognosis of TLE patients with drug therapy. In clinical diagnosis and treatment, such patients should be diagnosed and treated early.