Frequency of unilateral and bilateral mesial temporal sclerosis in primary and secondary epilepsy: a forensic autopsy study

The American Journal of Forensic Medicine and Pathology
E J RushingC L White

Abstract

Controversy exists regarding the pathogenetic relationship of mesial temporal sclerosis (MTS) to epileptogenesis. Some investigators view hippocampal sclerosis as the primary cause of temporal lobe epilepsy, whereas others interpret the changes to be the result of chronic seizure activity. The present autopsy-based study attempts to clarify the etiologic relationship between mesial temporal sclerosis and epilepsy. To investigate the assumption that bilateral MTS is more likely to be the result of chronic seizure activity associated with a seizure focus outside the hippocampus, two subject groups were identified. The first group comprised 43 patients who had no extrahippocampal pathology and were classified as having primary epilepsy. The second group comprised 35 patients who, had identifiable extrahippocampal pathology and were classified as having secondary epilepsy. Fifteen of the 35 cases of secondary epilepsy also had MTS; seven of these were unilateral and eight were bilateral. Of the 43 cases with primary epilepsy, only one had MTS, and it was unilateral. Significantly more cases of primary epilepsy than secondary epilepsy had no MTS (p < 0.001), suggesting that both unilateral and bilateral forms of MTS occur with great...Continue Reading

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Citations

May 2, 2000·Pediatric Neurology·S P MillerD L Arnold
Jul 1, 1999·Epilepsia·C JuhászH T Chugani
Mar 3, 2012·Neurosurgical Focus·Fernando L ValeSelim R Benbadis
Feb 19, 2014·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Andrea SalmonRichard S McLachlan

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