CHARACTERISTICS OF TEMPORAL-LOBE EPILEPSY WITH MESIAL TEMPORAL SCLEROSIS, WITH SPECIAL REFERENCE TO PSYCHOTIC EPISODES

This study investigates the histories and the clinical course of 111 p atients who had nonlesional temporal lobe epilepsy. We compared 61 pat ients with unilateral hippocampal sclerosis (UHS group) and 50 patient s with minimal change (MRI negative group) assessed on the basis of MR I. In agreement with previous reports, we confirmed statistically that patients in the UHS group strongly tended to have had febrile convuls ive status during early childhood or infancy and that habitual seizure s tended to begin at a younger age than the other subset of nonlesiona l temporal lobe epilepsy. Strikingly, episodes of psychoses, especiall y postictal psychoses, occurred significantly more often in the UHS gr oup than in the MRI negative group. Additional involvement of temporal neocortex further augmented this association. We stress the role of m esial temporal pathology, and its linkage to the temporal neocortex, i n the genesis of postictal psychoses.