Mesial temporal sclerosis syndrome in adult patients.

Magnetic resonance imaging (MRI) has become an essential tool in the work-u p of epilepsy. Since its appearance it has been possible to identify pathol ogies, such as hippocampal sclerosis (HS), that had previously only been de tected by histopathological assays. The aim of this study was to analyze th e clinical manifestations, EEG and the outcome of patients with HS as shown by MRI. We revised the clinical histories of 384 outpatients from the Epil epsy Center, Ramos Mejia Hospital, who had been studied by MRI. Thirty five of them (15.5%) had a diagnosis of HS, based on the structural changes obs erved on the images. Six patients were excluded because of incomplete clini cal data. Therefore, we studied 29 patients including 15 men. The mean age was 32.7 +/- 10.2 years (range: 19-58). All of them had partial seizures. T en subjects had had febrile convulsions (34.5%)in childhood. Neurological e xamination was normal in all subjects. Interictal EEG showed focal abnormal ities that were coincident in their location with the MRI abnormalities in 16 patients (55.1%). Fourteen patients (48.3%) showed right side hippocampa l lesions on MRI, thirteen on the left side (44.9%) and 2 bilateral HS (6.8 %). Twenty-seven patients (93.1%) had intractable epilepsy. Anterior tempor al lobectomy was performed in 3 subjects with good outcome. The identificat ion of these patients who present certain clinical and MRI characteristics, provides an opportunity to define the mesial temporal sclerosis syndrome. This could benefit patients in their prognosis and for specific treatments.