Association between mesial temporal sclerosis and suicidal behavior in patients with temporal lobe epilepsy: a 5-year prospective cohort study

Abstract

Background: Epilepsy is the most common neurologic disorder worldwide. As a chronic condition, it provokes a great burden for people who suffer it and it is a source of a lot of complications. In addition, it also predisposes to a loss of life expectancy because it increases the risk of suffering accidents and other pathologies. One of the leading, and poorly studied causes of death in epileptic patients is suicide, which may affect an important part of them. Numerous risk factors have been described, especially mental disorders, psychosocial or familiar stressors, antiepileptic drugs, type and frequency of seizures or presenting refractory epilepsy. Although 60% of patients with refractory epilepsy correspond to people with mesial temporal sclerosis, this lesion is not included among the risk factors for autolytic behavior. Objective: The aim of this study is to analyze whether the presence of mesial temporal sclerosis is associated independently with a major risk of developing suicidal behavior in patients with temporal lobe epilepsy. Methods: The study will be an observational analytic prospective cohort study with a follow-up of 5 years performed at Hospital Josep Trueta de Girona and Hospital Santa Caterina de Salt. Using a non-probabilistic consecutive sampling, patients aged 14 or more with current or new diagnosis of temporal lobe epilepsy will be recruited and divided depending on the presence of mesial temporal sclerosis. The two groups will be followed in order to analyze suicidal behavior appearance (ideation, attempt or completed suicide)