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Hippocampal sclerosis in temporal lobe epilepsy demonstrated by magnetic resonance imaging
Author(s) -
Berkovic Samuel F.,
Andermann Frederick,
Olivier André,
Ethier Roméo,
Melanson Denis,
Robitaille Yvon,
Kuzniecky Ruben,
Peters Terence,
Feindel William
Publication year - 1991
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410290210
Subject(s) - hippocampal sclerosis , hippocampus , hippocampal formation , magnetic resonance imaging , temporal lobe , epilepsy , coronal plane , medicine , neuroimaging , neuroscience , radiology , psychology
The value of magnetic resonance imaging in the detection of hippocampal sclerosis has been controversial. We studied 10 patients aged 22.5 ± 6.0 years with intractable temporal lobe epilepsy selected because of a history of a prolonged childhood convulsion, which is characteristic of a group of patients in whom hippocampal sclerosis is a constant finding. All 10 patients showed reduction in size of one hippocampus associated with increased signal intensity on T2‐weighted magnetic resonance images. These changes were reliably detected on coronal spin‐echo images, perpendicular to the long axis of the hippocampus. Appreciation of the normal imaging anatomy of the hippocampus allowed correct interpretation of the relative changes in signal intensities of the hippocampus and adjacent temporal horn on sequential echo images. The side of the abnormal hippocampus on magnetic resonance imaging accorded with the electroencephalographic localization in all 10 patients, and with the lateralization of the early convulsions in all 6 patients where this was known. Temporal lobectomy was performed in all 10 patients. Hippocampal sclerosis was confirmed in the 3 patients in whom hippocampal tissue was available for histological examination. The value of this technique was reinforced by the excellent postoperative results, with 80% being seizure free at a mean follow‐up time of 33 ± 4 months.