Abstract
Hippocampal sclerosis is one of the most common causes of focal epilepsy. At the same time, hippocampal sclerosis is the most common surgical substrate in focal pharmacoresistant epilepsies. The hippocampus has a specific anatomical structure consisting of a total of four sectors. In a physiological context, the hippocampus is essential in many neuropsychological processes, so hippocampal sclerosis (an entity recognized and associated with epilepsy as early as the 19th century) is very interesting in terms of research. The pathohistological pattern of hippocampal sclerosis is now very precisely represented, which helps uniform recognition. The causes of hippocampal sclerosis are not known, but so far, numerous factors have been identified that are associated with the occurrence of this pathological process. There is no doubt that excitotoxicity, along with changes in the redox system, is the most essential pathophysiological mechanism. Hippocampal sclerosis is clinically very recognizable. Epilepsy patients whose basis is hippocampal sclerosis have very typical epileptic seizures consisting of an epigastric aura followed by a focal epileptic seizure characterized by confusion of consciousness and oroalimentary automatisms. Today, thanks to modern neuroimaging (primarily magnetic resonance imaging), the detection of this pathological pattern is exact and unambiguous.
Publisher
Centre for Evaluation in Education and Science (CEON/CEES)
Reference37 articles.
1. Lamberink HJ, Otte WM, Blümcke I, Braun KPJ; European Epilepsy Brain Bank writing group; study group; European Reference Network EpiCARE. Seizure outcome and use of antiepileptic drugs after epilepsy surgery according to histopathological diagnosis: a retrospective multicentre cohort study. Lancet Neurol. 2020 Sep;19(9):748-757. doi: 10.1016/S1474-4422(20)30220-9;
2. Van Paesschen W, Duncan JS, Stevens JM, Connelly A. Longitudinal quantitative hippocampal magnetic resonance imaging study of adults with newly diagnosed partial seizures: one-year follow-up results. Epilepsia 1998; 39:633-9. doi: 10.1111/j.1528-1157.1998.tb01432.x;
3. Blumcke I, Spreafico R, Haaker G, Coras R, Kobow K, Bien CG, et al.; EEBB Consortium. Histopathological Findings in Brain Tissue Obtained during Epilepsy Surgery. N Engl J Med. 2017 Oct 26; 377:1648-56. doi: 10.1056/NEJMoa1703784;
4. Eriksson PS, Perfilieva E, Björk-Eriksson T, Alborn AM, Nordborg C, Peterson DA, Gage FH. Neurogenesis in the adult human hippocampus. Nat Med. 1998; 4:1313-7. doi: 10.1038/3305;
5. Duvernoy HM. The Human Hippocampus Functional Anatomy, Vascularization And Serial Sections with MRI. Berlin, Heidelberg: Springer-Verlag Berlin Heidelberg, 2005;