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

• Published in: Arquivos de neuro-psiquiatria Vol. 70; no. 5; pp. 319 - 324
• Main Authors: Jardim, Anaclara Prada, Neves, Rafael Scarpa da Costa, Caboclo, Luís Otávio Sales Ferreira, Lancellotti, Carmen Lucia Penteado, Marinho, Murilo Martinez, Centeno, Ricardo Silva, Cavalheiro, Esper Abrão, Scorza, Carla Alessandra, Yacubian, Elza Márcia Targas
• Format: Journal Article
• Language: English
• Published: Brazil Academia Brasileira de Neurologia - ABNEURO 01-05-2012; Academia Brasileira de Neurologia (ABNEURO)
• Subjects: Adult; Anterior Temporal Lobectomy; Cell Count; Data processing; epilepsia do lobo temporal; Epilepsy; Epilepsy, Temporal Lobe - complications; Epilepsy, Temporal Lobe - pathology; Epilepsy, Temporal Lobe - surgery; esclerose hipocampal; esclerose mesial temporal; Female; Hippocampus; Hippocampus - pathology; Humans; Male; Neurons - pathology; NEUROSCIENCES; patologia; Prognosis; prognóstico cirúrgico; PSYCHIATRY; Retrospective Studies; Sclerosis; Seizures; Temporal lobe; Temporal Lobe - pathology; Treatment Outcome; epilepsy; temporal lobe; prognóstico cirúrgico; pathology; epilepsia do lobo temporal; mesial temporal sclerosis; patologia; hippocampal sclerosis; esclerose mesial temporal; esclerose hipocampal; surgical prognosis
• ISSN: 0004-282X; 1678-4227; 1678-4227; 0004-282X
• DOI: 10.1590/S0004-282X2012000500003

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.
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.
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).
Quantitative evaluation of hippocampal neuronal loss patterns predicts surgical outcome in patients with TLE-MTS.