Unilateral mesial temporal atrophy after a systemic insult as a possible etiology of refractory temporal lobe epilepsy: case report

Arquivos de Neuro-Psiquiatria

Arthur Cukiert²  Mario Sergio Duarte Andrioli²  Ana Regina Caner-cukiert¹ 

[1] ,Hospital Brigadeiro Serviço de Cirurgia de Epilepsia Clínica de Diagnóstico e Terapêutica das Epilepsias

关键词: epilepsy;    mesial temporal sclerosis;    systemic insult;    febrile convulsions;    epilepsia;    esclerose mesial temporal;    insulto sistêmico;    convulsão febril;   

DOI  :  10.1590/S0004-282X1997000400023

来源: SciELO

【 摘 要 】

Mesial temporal sclerosis is the main pathological substrate present in refractory temporal lobe epilepsy and its presence is often related to the occurrence of febrile seizures in infancy. There is an on-going discussion on the nature of mesial temporal sclerosis as it related to epilepsy: cause or consequence. A previously normal child developed hyperosmolar coma after abdominal surgery at the age of 6. Three months afterwards he developed simple and complex partial seizures with an increasing frequency and refractory to multiple mono-and polytherapic drug regimens. He was evaluated for surgery at the age of 13. Ictal and interictal recordings showed left temporal lobe abnormalities. Early CT scaning suggested left temporal atrophy. MRI showed mesial temporal sclerosis. Neuropsichological testing showed verbal memory deficits and he passed a left carotid artery amytal injection. He was submitted to a cortico-amygdalo-hippocampectomy and has been seizure-free since then. The clinical data obtained from this patient suggest that at least in this case mesial temporal sclerosis would be related to the cause of epilepsy and not resultant from repeated seizure activity.

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