Mesial temporal sclerosis
The mesial temporal sclerosis , also called hippocampal sclerosis or hippocampal sclerosis called, is the most common neuropathological findings in refractory temporal lobe epilepsy .
It was first recognized with the naked eye in 1825/26 by the two French psychiatrists Camille G. Bouchet and Jean Baptiste Cazauvieilh. a. Described in more detail in 1868 by the German-Austrian neurologist and psychiatrist Theodor Meynert and in 1880 by the German psychiatrist Wilhelm Sommer .
Histologically, which is mesial temporal sclerosis by nerve cell failures in the hippocampal formation characterized, four different types can be distinguished by their distribution pattern. While the classic form of hippocampal sclerosis (type 1A according to Blümcke ) and severe hippocampal sclerosis (type 1B according to Blümcke) have a more favorable prognosis, with an atypical distribution pattern with nerve cell deficiencies in the area of the CA2, CA3 and CA4 region (terminal sclerosis, Blümcke type 3) After epilepsy surgery, freedom from seizures can be achieved less often.
| Type | Distribution pattern | frequency | Freedom from seizures (12 months postoperatively) |
|---|---|---|---|
| Type 1A | Nerve cell failures in the area of the CA1 region, moderate failures in CA2, CA3 and CA4 (classic distribution pattern ) | 19% | 72% |
| Type 1B | Nerve cell failures in the area of the CA1 region, significant failures in CA2, CA3 and CA4 (severe hippocampal sclerosis) | 53% | 73% |
| Type 2 | isolated nerve cell failures in the area of the CA1 region, no significant failures in CA2, CA3 and CA4 (CA1 sclerosis) | 6% | 67% |
| Type 3 | Nerve cells in the area of the CA1 region preserved, failures in CA2, CA3 and CA4 ( terminal sclerosis) | 7% | 29% |
literature
Individual evidence
- ↑ Bouchet CG, Cazauvieilh JB .: De l'épilepsie considérée dans ses rapports avec l'aliénation mental. Research on nature et la siège de ces deux maladies, etc. (première partie). In: Arch Gén Méd . tape 9 , 1825, p. 510-542 .
- ↑ Bouchet CG, Cazauvieilh JB .: De l'épilepsie considérée dans ses rapports avec l'aliénation mental. Research on nature et la siège de ces deux maladies, etc. (deucième partie). In: Arch Gén Méd . tape 10 , 1826, pp. 5-50 .
- ↑ Meynert T .: Studies on the pathological-anatomical material of the Vienna insane asylum. In: Vjhrschr Psychiatrie . tape 1 , 1867, p. 381-402 .
- ↑ Sommer W .: Disease of the Ammon's horn as an aetiological factor in epilepsy. In: Arch Psychiatrie Nervenkrankh . tape 10 , 1880, p. 631-675 .
- ↑ Ingmar Blümcke et al .: A new clinico-pathological classification system for mesial temporal sclerosis . In: Acta Neuropathologica . tape 113 , no. 3 , March 2007, p. 235–244 , doi : 10.1007 / s00401-006-0187-0 , PMID 17221203 (English).