Minor physical anomalies more common in epilepsy

Patients with epilepsy more commonly have minor physical anomalies (MPA), suggesting a neurodevelopmental dimension to epilepsy, a recent study has found.

“Assessment of these signs may contribute to the clarification of the underlying aetiology,” the researchers said. “Moreover, as increased frequency of MPAs may indicate pharmacoresistance, the identification of patients with high number of MPAs could allow evaluation for nonpharmacological treatment in time.”

The study included 235 patients grouped into the following: acquired, nongenetic, nondevelopmental epilepsy (n=63); temporal lobe epilepsy with hippocampal sclerosis (n=27); epilepsy with cortical dysgenesis aetiology (n=29); cryptogenic epilepsy (n=69); and idiopathic generalized epilepsy (n=47). Thirty healthy adults were also included as controls. MPAs were identified during a physical examination using the Méhes Scale, looking out for 57 minor signs.

Results showed that MPA frequency was affected by the subtype of epilepsy (p<0.001). Pairwise analyses revealed that MPAs in general were significantly more common in all patient subgroups (p<0.001 for all) except for those with acquired epilepsy. Meanwhile, furrowed tongue (p<0.001) and high-arched palate (p=0.001) were both more common in all epilepsy subgroups except for temporal lobe epilepsy.

Of note, binary logistic regression analysis found a significant interaction between MPA frequency and epilepsy drug resistance (odds ratio, 4.19, 95 percent confidence interval, 1.37–12.80; p=0.012).