Long-term outcome of treatment-naïve patients with mesial temporal lobe epilepsy with hippocampal sclerosis: A retrospective study in a single center

•Long-term follow-up of 84 treatment-naïve patients with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS).•ASM provided encouraging treatment outcomes in drug-naïve MTLE-HS patients, with 64% achieving seizure freedom (SF) and 41% achieving complete SF in the last year of follow-up.•Remission and relapse were common in MTLE-HS, with 46% and 51% of patients experiencing a fluctuating course with periods of SF and complete SF, respectively.•Patients with MTLE-HS may require more ASMs for seizure control.