Evidence map›Paper›PMID 40993433›Full record

ArticleJournal of neurology2025

Temporal trends indicate an epidemiological shift in the pathology of mesial temporal lobe epilepsy.

Christoph Helmstaedter, Sarah Al-Haj Mustafa, Juri-Alexander Witt

Abstract read
In one paragraph

Article in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Quantitative dual-tracerEuropean journal of nuclear medicine and molecular imaging · 2026
    Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Christoph HelmstaedterDepartment of Epileptology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. Christoph.Helmstaedter@ukbonn.de.ORCID http://orcid.org/0000-0002-6608-6244
Sarah Al-Haj MustafaDepartment of Epileptology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
Juri-Alexander WittDepartment of Epileptology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent multicenter studies suggest a temporal trend of a decreasing number of patients with classic early-onset mesial temporal lobe epilepsy (mTLE) with ammon's horn sclerosis (mTLE-AHS). In parallel, the awareness of late-onset mTLE patients with suspected limbic encephalitis (sLE) is increasing. To evaluate a potential epidemiological shift, a large cohort of mTLE patients collected over 4 decades was analyzed.

methodsAnonymized data sets of a monocentric cohort of 1,556 patients with the diagnosis of mTLE, who underwent their very first neuropsychological assessment between 1986 and 2024 in the Department of Epileptology at the University Hospital Bonn in Germany, were retrospectively evaluated in regard to temporal trends of age, age at epilepsy onset, neuropsychological performance, and MRI pathology. Five-year intervals were evaluated.

resultsMost significant was a trend of an increasing age at epilepsy onset over time (from 12 to 36 years), education and IQ increased over time, impairments became less global, and verbal/figural memory impairments became less marked and discriminative over time. While the number of patients with mTLE remained quite stable since 1996 (50-60% of all TLE patients seen), patients with early-onset mTLE-AHS (n = 1079, average age at epilepsy onset: 16 years) faded over time (from 100 to 32%), while the patients with late-onset mTLE suspicious of limbic encephalitis (N = 477, average age at epilepsy onset: 40 years) became increasingly prevalent (from 0 to 68%).

conclusionsTrends of changing etiologies as well as altering clinical and neuropsychological features of patients with mTLE suggest an epidemiological shift over the past decades. Overlapping distributions of fading early-onset classic mTLE-AHS and an increasing influx of late-onset sLE fit the clinical observations and demand retrospective follow-up studies in other countries/regions to disentangle triggering factors. Prospective studies should investigate temporal trends in autoantibody subgroups of patients with sLE.

Indexed as

Epilepsy, Temporal LobeAdolescentAdultAge of OnsetChildFemaleGermanyHumansLimbic EncephalitisMagnetic Resonance ImagingMaleMiddle AgedNeuropsychological TestsRetrospective StudiesSclerosisYoung AdultAmmon´s horn sclerosisEpidemiological shiftHippocampusLimbic encephalitisMesial temporal lobe epilepsyTemporal trends

Identifiers

PMID40993433
PMCPMC12460450

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.