Thalamic changes with mesial temporal sclerosis: MRI

We reviewed the preoperative images of 28 patients with pathologically prov en mesial temporal sclerosis, to assess thalamic asymmetry and signal chang e. A further 25 nonsurgical patients with temporal lobe epilepsy and unequi vocal, unilateral changes of mesial temporal sclerosis, and 20 controls, we re also reviewed. None of the control group had unequivocal asymmetry of th e thalamus. There was an ipsilateral asymmetrically small thalamus in five (18 %) of the surgical group and in three (12 %) of the nonsurgical patient s. In four cases there was thalamic signal change. In three patients with t halamic volume loss there was ipsilateral hemiatrophy. All patients with an asymmetrically small thalamus had an asymmetrically small fornix and all b ut one a small ipsilateral mamillary body.