Hippocampal sclerosis and the syndrome of medial temporal lobe epilepsy

Medial temporal lobe epilepsy due to hippocampal sclerosis is the most common epileptic syndrome and, if medically refractory, is a progressive disorder. Advances over the past decade allow this clinicopathological syndrome to be diagnosed in vivo. Many patients with hippocampal sclerosis become refractory to antiepileptic medications and are at risk of progressive hippocampal damage, cognitive deterioration and other disabling manifestations of refractory epilepsy. Fortunately, if hippocampal sclerosis is detected early and treated surgically, most patients with this syndrome can be rendered seizure-free, thus sparing them from further progression and disability.