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Hippocampal sclerosis (HS) or mesial temporal sclerosis (MTS) is a neuropathological condition with severe neuronal cell loss and gliosis in the hippocampus. [1] Neuroimaging tests such as magnetic resonance imaging (MRI) and positron emission tomography (PET) may identify individuals with hippocampal sclerosis. [ 2 ]
A common associated brain abnormality is mesial temporal sclerosis. [15] Mesial temporal sclerosis is a specific pattern of hippocampal neuronal loss accompanied by hippocampal gliosis and atrophy. [18] Complex partial seizures occur when excessive and synchronous electrical brain activity causes the impaired awareness and responsiveness. [19]
Temporal lobe epilepsy is the most common focal onset epilepsy, and 80% of temporal lobe epilepsy is mesial (medial) temporal lobe epilepsy, temporal lobe epilepsy arising from the inner part of the temporal lobe that may involve the hippocampus, parahippocampal gyrus or amygdala.
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Identification of common lesions associated with epilepsy like focal cortical dysplasia, mesial temporal sclerosis, microencephalocele, and heterotopia require thorough review of images by trained clinicians as the changes can be very subtle and easily missed if not specifically evaluated for.
Seizures in temporal lobe epilepsy can affect the normal development of new neurons and can cause tissue damage. Hippocampal sclerosis including Ammon's horn sclerosis that is specific to the mesial temporal lobe, is the most common type of such tissue damage.
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