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Chapter 53 - Hippocampal sclerosis

from Section 3 - Symptomatic epilepsy

Published online by Cambridge University Press:  05 March 2012

By
Fernando Cendes  and
Márcia Elisabete Morita
Edited by
Simon D. Shorvon ,
Frederick Andermann  and
Renzo Guerrini
Simon D. Shorvon
Affiliation:
National Hospital for Neurology and Neurosurgery, London
Frederick Andermann
Affiliation:
Montreal Neurological Hospital and Institute
Renzo Guerrini
Affiliation:
Child Neurology Unit, Meyer Pediatric Hospital, Florence
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Summary

Hippocampal sclerosis (HS) has been recognized as the most commonly encountered pathological substrate of mesial temporal lobe epilepsy (MTLE). The pathological condition was initially described by early neuropathologists based on postmortem material. Studies in familial MTLE are also important for better understanding of the pathogenesis of HS. HS identified by magnetic resonance imaging (MRI) has been associated with poor medical control of seizures. Neurologic examination is usually normal except for facial asymmetry and memory deficits, which are material-specific for the side of ictal onset. Interictal electroencephalogram (EEG) findings in patients with MTLE typically include unilateral or bilaterally independent mesial temporal spikes, best seen with basal derivations. Treatment should start with a first-line antiepileptic drug (AED) in monotherapy, the dose of which is increased until seizure freedom or the occurrence of side effects such as tiredness, dizziness, diploplia, or gait disturbance.

Keywords

cblC disordercobalamin metabolismfolate metabolismneurologic syndromesproton-coupled folate transportermegaloblastic anemianeuroimagingseizuresserum cobalamin
Type
Chapter
Information
The Causes of Epilepsy
Common and Uncommon Causes in Adults and Children
 , pp. 363 - 372
Publisher: Cambridge University Press
Print publication year: 2011

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