The condition called mesial temporal sclerosis is
closely related to temporal lobe epilepsy, a type
of partial (focal) epilepsy in which the seizure initiation
point can be identified within the temporal lobe of
the brain. Mesial temporal sclerosis is the loss of
neurons and scarring of the deepest portion of the
temporal lobe and is associated with certain brain
injuries.
Brain damage from traumatic injury, infection, a brain
tumor, a lack of oxygen to the brain, or uncontrolled
seizures is thought to cause the scar tissue to form,
particularly in the hippocampus, a region of the temporal
lobe. The region begins to atrophy; neurons die and
scar tissue forms. This damage is thought to be a
significant cause of temporal lobe epilepsy. In fact,
70 percent of temporal lobe epilepsy patients have
some degree of mesial temporal sclerosis. It also
appears that the mesial temporal sclerosis can be
worsened by additional seizures.
Symptoms
Mesial temporal sclerosis usually causes partial
(focal) epilepsy. This seizure disorder can cause
a variety of symptoms such as strange sensations,
changes in behavior or emotions, muscle spasms, or
convulsions. The seizures usually are localized in
the brain, but they may spread to become generalized
seizures, which involve the entire brain and may cause
a sudden loss of awareness or consciousness.
Treatment is aimed at controlling seizures. Treatment
for epilepsy resulting from mesial temporal lobe sclerosis
typically involves medical and surgical therapy. Anticonvulsant
(anti-seizure) medications are typically used to treat
this disorder.
Surgical therapy involves either temporal lobectomy
or vagus nerve stimulation (VNS). Temporal lobectomy
has been proven to be superior to prolonged medical
therapy in patients with temporal lobe epilepsy. Vagus
nerve stimulation may be used as an aid in reducing
seizure frequency in patients with partial onset epilepsy.
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