Prognostic factors in the surgical treatment of medically intractable epilepsy associated with mesial temporal sclerosis. Hippocampal sclerosis an overview sciencedirect topics. The neuropathological lesion associated with tle, mesial temporal sclerosis. Magnetic resonance imaging mri has be come an essential tool in the workup of epilepsy. Mesial temporal lobe epilepsy with hippocampal sclerosis. Tailored resection strategies including selective amygdalahippocampectomy are established treatment modalities and offer a favourable outcome with up to 80% postoperative seizure freedom within the first 2 years 1, 2, 14, 17, 45. Temporal lobe epilepsy caused by mesial temporal sclerosis and temporal neocortical lesions. Mesial temporal sclerosis radiology reference article. The evaluation of cortical hubs, even in the spike. Pdf mesial temporal sclerosis syndrome in adult patients. Tailored resection strategies including selective amygdalahippocampectomy are established treatment modalities and offer a favourable outcome with up to 80% postoperative seizure freedom within the first 2 years 1, 2, 14, 17, 45, 47. Alteraciones extrahipocampicas en epilepsia temporal mesial.
Epilepsia del lobulo temporal, esclerosis mesial del hipocampo abstract in order to more precisely define temporomedial epilepsy with hippocampal sclerosis, we evaluated 20 patients with magnetic resonance imaging findings of it. Mesial temporal sclerosis syndrome in adult patients. Both patients were seizure free after surgery for 6 years, but presented again with seizures after that time. The term is used chiefly for such a hardening of the nervous system due to hyperplasia of the connective tissue or for hardening of the blood vessels.
A new clinicopathological classification system for. Hippocampal sclerosis is a frequent pathologic finding in communitybased dementia. Histologicamente presenta atrofia y gliosis del hipocampo. Esclerosis temporal mesial y otras epilepsias del lobulo temporal. A new clinicopathological classification system for mesial. Freesurfer is documented and is available for free. In the brains diagnosed with mesial temporal sclerosis mts, these abnormalities involved not only the hippocampus but also other structures of the limbic system and medial temporal lobe. Mesial temporal sclerosis is the most frequent cause of drugresistant temporal lobe epilepsy but has a satisfactory response to surgery, and is considered infrequent in children.
Is mesial temporal sclerosis a necessary component of temporal. Esclerosis multiple diagnostico serieanatomia normal. Clinical manifestations preexisting complex febrile convulsions are common. Perfil neuropsicologico en pacientes con epilepsia del lobulo. Synonyms for hippocampal sclerosis include ammon horn sclerosis, mesial temporal sclerosis, and incisural sclerosis. Mesial temporal sclerosis mts is a progressive drugresistant epileptic syndrome which requires rapid, effective diagnosis and treatment. Limbic system abnormalities associated with mesial temporal. The overall percentage overlap between automated segmentations was 92. Longterm outcome of mild mesial temporal lobe epilepsy. Simple focal seizures are the initial nonfebrile seizures followed by complex focal.
In five patients with mesial temporal sclerosis, the authors verified the precision and reproducibility of hippocampal segmentations with deformationbased magnetic resonance mr imaging. Since its appearance it has been possible to identify pathologies, such as hippocampal sclerosis hs. Hippocampal sclerosis is associated with chronic epilepsy and is characterized by severe segmental neuronal loss and gliosis in one or more hippocampal regions. Esclerosis multiple informacion en espanol national. Limbic system abnormalities associated with mesial temporal sclerosis. Many of these changes are evident at magnetic resonance imaging. Esclerosis mesial temporal emt free download as powerpoint presentation. To evaluate the clinical, electrographic and radiological spectrum of the disease in children. Experts discussed the definition, natural history, pathologic features, pathogenesis, electroclinical, neurophysiological, neuropsychological, structural and functional imaging findings, as well as surgical outcome in mesial temporal lobe epilepsy with hippocampal sclerosis mtle. All patients had oroalimentary automatisms, and 14 patients 70% also had other automatisms.
Studies suggest an increased incidence among family members and an association with precipitating insults during the first four to five years of life. Neurological and mental state usually normal prior to seizure onset. Simple focal seizures are the initial nonfebrile seizures followed by. Crisis comportamentales en epilepsia temporal mesial. The final diagnosis was five cases of hippocampal sclerosis and focal dysplasia, and two corresponding to mesial sclerosis. Mesial temporal lobe epilepsy with hippocampal sclerosis is a. Mesial temporal sclerosis mts, also commonly referred to as hippocampal sclerosis, is the most common association with intractable temporal lobe epilepsy tle 2,3,5. Mesial temporal sclerosis mts is the most recognized finding in drug resistant, chronic temporal lobe epilepsies. Esclerosis temporal mesial en epilepsiadel lobulo temporal. However, all the nl patients who were not free of seizures had had an incomplete lesion resection. In the diagnosis of mesial temporal sclerosis mts, sensitivity. There was a tendency for mts patients to have a higher seizurefree postsurgical outcome 87% versus 60%, p 0. Oct 18, 2011 the etiology of mesial temporal sclerosis is unclear.
Temporal lobe epilepsy caused by mesial temporal sclerosis and. Six patients whose brain volumetry results showed correlation with those obtained through the eeg showed no postsurgical deficits and currently are free of seizures. We conclude that there are a number of clinico electrical. Sclerosis definition of sclerosis by medical dictionary.
Hippocampal sclerosis hs is a neuropathological condition with severe neuronal cell loss and gliosis in the hippocampus, specifically in the ca1 cornu ammonis area 1 and subiculum of the hippocampus. Mesial temporal sclerosis and temporal lobe epilepsy. Limbic system abnormalities associated with mesial. It is seen in up to 65% of autopsy studies, although significantly less on imaging. Scribd is the worlds largest social reading and publishing site. Mesial temporal sclerosis in epilepsy pubmed central pmc. In the brains diagnosed with mesial temporal sclerosis mts, these abnormalities involved not only the hippocampus but also other structures. Pdf diagnosis of mesial temporal sclerosis with magnetic. Histologically there is atrophy and gliosis of the.