From the Research
Mesial temporal sclerosis is a rare condition in the general population, affecting approximately 1 in 100,000 people, and is most commonly associated with temporal lobe epilepsy. The condition involves the hardening and atrophy of the mesial temporal structures, particularly the hippocampus, due to neuronal loss and gliosis. According to a study published in 2006 1, the prevalence of mesial temporal sclerosis in children is approximately 0.77%, and it is always associated with epilepsy. The development of mesial sclerosis is often associated with precipitating factors such as prolonged febrile seizures in childhood, traumatic brain injury, or central nervous system infections.
Some key points to consider when evaluating mesial temporal sclerosis include:
- The condition is typically diagnosed through high-resolution MRI, which shows characteristic hippocampal volume loss and increased signal intensity on T2-weighted images.
- Mesial temporal sclerosis is the most frequent pathological abnormality identified in patients with temporal lobe epilepsy, present in about 65-70% of surgical specimens from patients undergoing surgery for drug-resistant temporal lobe epilepsy, as reported in a study published in 2014 2.
- While it can occasionally be found incidentally on MRI scans of asymptomatic individuals, such cases are extremely uncommon.
- A study published in 1997 3 found that the combination of inversion recovery and T1-weighted images correctly identifies mesial temporal sclerosis in most patients, with a sensitivity of 97% using quantitative volumetry.
Overall, mesial temporal sclerosis is a rare condition that is most commonly associated with temporal lobe epilepsy, and its diagnosis and management should be guided by high-quality evidence and individual patient characteristics.