Fact-sheet: Mesial temporal sclerosis
Updated on 04/18/2017 at 7:12 AM
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Definition
Neuronal loss associated with gliosis of the mesiotemporal region
Clinical features
Leading cause of drug-resistant temporal lobe epilepsy in children. Generally, complex partial temporal seizures: autonomic signs, language disturbance, abnormal epigastric sensation, oro-buccal automatisms
MRI
- Hippocampal atrophy (caution: gliosis may compensate for volume loss)
- 3D T1 IR hippocampal volumetry
- Loss of hippocampal digitations
- T2 hyperintensity - T2 FLAIR
- Spectroscopy: decrease in NAA/Cho+Cr ratio and increase in Cho/Cr ratio
Management
In the majority of cases, failure of antiepileptic treatment within 1 year.
Surgical treatment by hippocampal resection: good results