Hippocampal sclerosis

Temporal lobe epilepsy is the most commonly en-countered partial epilepsy syndrome in adults. Many patients are refractory to medications and therefore considered for surgical treatment. Pathologic series and modern imaging demon-strate evidence of hippocampal (mesial temporal) sclerosis (HS), characterized by cell loss in the hippocampal pyramidal cell layer and hilus with associated volume loss and gliosis, in a substan-tial fraction of affected individuals. Human and animal studies indicate that HS may be the conse-quence or the cause of chronic epilepsy, or in some cases, both. While many patients with HS have seizures beginning in childhood, the discov-ery of hippocampal pathology in patients wit