Arquivos de Neuro-Psiquiatria (May 2012)

Temporal lobe epilepsy with mesial temporal sclerosis: hippocampal neuronal loss as a predictor of surgical outcome

  • Anaclara Prada Jardim,
  • Rafael Scarpa da Costa Neves,
  • Luís Otávio Sales Ferreira Caboclo,
  • Carmen Lucia Penteado Lancellotti,
  • Murilo Martinez Marinho,
  • Ricardo Silva Centeno,
  • Esper Abrão Cavalheiro,
  • Carla Alessandra Scorza,
  • Elza Márcia Targas Yacubian

DOI
https://doi.org/10.1590/S0004-282X2012000500003
Journal volume & issue
Vol. 70, no. 5
pp. 319 – 324

Abstract

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OBJECTIVE: To analyze retrospectively a series of patients with temporal lobe epilepsy (TLE) and mesial temporal sclerosis (MTS), and the association of patterns of hippocampal sclerosis with clinical data and surgical prognosis. METHOD: Sixty-six patients with medically refractory TLE with unilateral MTS after anterior temporal lobectomy were included. Quantitative neuropathological evaluation was performed on NeuN-stained hippocampal sections. Patient's clinical data and surgical outcome were reviewed. RESULTS: Occurrence of initial precipitating insult (IPI), as well as better postoperative seizure control (i.e. Engel class 1), were associated with classical and severe patterns of hippocampal sclerosis (MTS type 1a and 1b, respectively). CONCLUSION: Quantitative evaluation of hippocampal neuronal loss patterns predicts surgical outcome in patients with TLE-MTS.

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