You have full text access to this OnlineOpen article

Mesial temporal lobe epilepsy: Clinical and neuropathologic findings of familial and sporadic forms

  1. Luciana Patrízia A. Andrade-Valença1,2,
  2. Marcelo Moraes Valença3,
  3. Tonicarlo Rodrigues Velasco1,
  4. Carlos Gilberto Carlotti Jr4,
  5. João Alberto Assirati4,
  6. Orfa Yineth Galvis-Alonso1,
  7. Luciano Neder5,
  8. Fernando Cendes6,
  9. João Pereira Leite1

Article first published online: 20 FEB 2008

DOI: 10.1111/j.1528-1167.2008.01551.x

Issue

Epilepsia

Epilepsia

Volume 49, Issue 6, pages 1046–1054, June 2008

Additional Information

How to Cite

Andrade-Valença, L. P. A., Valença, M. M., Velasco, T. R., Carlotti, C. G., Assirati, J. A., Galvis-Alonso, O. Y., Neder, L., Cendes, F. and Leite, J. P. (2008), Mesial temporal lobe epilepsy: Clinical and neuropathologic findings of familial and sporadic forms. Epilepsia, 49: 1046–1054. doi: 10.1111/j.1528-1167.2008.01551.x

Author Information

  1. 1

    Department of Neurology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil

  2. 2

    Division of Neurology, University of Pernambuco, Recife, Brazil

  3. 3

    Departments of Neurology, Neurosurgery, and Psychiatry, Federal University of Pernambuco, Recife, Brazil

  4. 4

    Departments of Neurosurgery

  5. 5

    Pathology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil

  6. 6

    Department of Neurology, University of Campinas—Unicamp—São Paulo, Brazil

*Address correspondence to Dr. Luciana P. A. Andrade-Valença, Division of Neurology, University of Pernambuco, Recife 50.100-010, Pernambuco, Brazil. E-mail: lupatrizia@yahoo.com.br

Publication History

  1. Issue published online: 20 FEB 2008
  2. Article first published online: 20 FEB 2008
  3. Accepted January 18, 2008; Online Early publication February 21, 2008.

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (437K)

Keywords:

  • Hippocampal sclerosis;
  • Familial;
  • Sprouting;
  • Mossy fiber;
  • Pathology;
  • Epilepsy

Summary

Purpose: To evaluate the clinical and hippocampal histological features of patients with mesial temporal lobe epilepsy (MTLE) in both familial (FMTLE) and sporadic (SMTLE) forms.

Methods: Patients with FMTLE (n = 20) and SMTLE (n = 39) who underwent surgical treatment for refractory seizures were studied at the University of São Paulo School of Medicine at Ribeirão Preto. FMTLE was defined when at least two individuals in a family had clinical diagnosis of MTLE. Hippocampi from all patients were processed for Nissl/HE and Timm's stainings. Both groups were compared for clinical variables, hippocampal cell densities, and intensity of supragranular mossy fiber staining.

Results: There were no significant differences between FMTLE and SMTLE groups in the following: age at the surgery, age of first usual epileptic seizure, history of initial precipitating injury (IPI), age of IPI, latent period, ictal and interictal video-EEG patterns, presence of hippocampal atrophy and signal changes at MRI, and postoperative outcome. In addition, no differences were found in cell densities in hippocampal cornu ammonis subfields (CA1, CA2, CA3, CA4), fascia dentata, polymorphic region, subiculum, prosubiculum, and presubiculum. However, patients with SMTLE had greater intensity of mossy fiber Timm's staining in the fascia dentata-inner molecular layer (p< 0.05).

Discussion: Patients with intractable FMTLE present a clinical profile and most histological findings comparable to patients with SMTLE. Interestingly, mossy fiber sprouting was less pronounced in patients with FMTLE, suggesting that, when compared to SMTLE, patients with FMTLE respond differently to plastic changes plausibly induced by cell loss, neuronal deafferentation, or epileptic seizures.

View Full Article (HTML) Get PDF (437K)