In mesial temporal lobe epilepsy patients with hippocampal sclerosis (MTLE-HS) syndrome, extrahippocampal alterations (EHA) are frequently described on MRI studies. The objectives of the study were, in patients with this syndrome, to evaluate the frequency of EHA and to correlate these findings with some of its clinical characteristics.
Were examined MTLE-HS patients diagnosed by high resolution MRI. The following EHA were considered: atrophy of the temporal lobe (TLA), of the parahippocampal gyrus (PHA), of the fornix (FA) and the mammillary bodies (MBA). We analyzed the variables age, age at the beginning of the epilepsy, time of evolution, history of febrile convulsions (FC) and familial epilepsy, history of status, secondary generalization of the seizures and response to the pharmacological treatment.
Of the 54 patients included, only 4 of them didn鈥檛 show any EHA. Eighteen (33.3%) had TLA; 44 (81.4%) PHA; 29 (53.7%) FA and 23 (42.5%) MBA. EHA were analyzed in a population of 17 controls. Anyone of the controls showed TLA or PHA, 3 showed FA (p< 0.02) and 2 MBA (p< 0.04). The FC was associated to PHA [OR = 9.9 (1.1-225); p = 0.002]. There were no differences in the rest of the variables that were analyzed.
In MTLE-HS there is an extension of the damage beyond the hippocampus, which would be indicative of involvement of the neuronal network rather an injury in a particular anatomical structure. The association between PHA and the presence of FC may suggest a common pathophysiological mechanism of disturbance.