Mesial Temporal Sclerosis

What Is Mesial Temporal Sclerosis?

The left and right medial temporal lobes of the brain assist in memory formation. They include the hippocampus and the amygdala. Sclerosis is abnormal hardening of tissue. Mesial temporal sclerosis is the scarring of the medial (middle or on the centerline of the body) temporal lobes of the brain. Scarring of the hippocampus is the most common form; this condition is called hippocampal sclerosis.

Often mesial temporal sclerosis is found concurrent with temporal lobe epilepsy or another pathology.

Causes and Symptoms of Mesial Temporal Sclerosis

Sometimes a lack of oxygen, an infection, trauma or continuing seizures contribute to the development of mesial temporal sclerosis. However, the cause is not always known.

Symptoms of mesial temporal sclerosis are generally associated with focal (partial) epilepsy. These include:

  • muscle spasms or convulsions
  • behavioral changes
  • strange sensations such as seeing auras or
  • seizures

Diagnosis of Mesial Temporal Sclerosis

An optimized high-resolution MRI, such as the ones we use at our epilepsy centers in the NY area, can show mesial temporal sclerosis that other general MRIs often miss.

Medical scans such as PET (positron emission tomography) scans or SPECT (single-photon emission computed tomography) scans and electroencephalograms (EEGs) can help determine where the sclerosis is and where the seizures originate.

Surgical Treatments for Mesial Temporal Sclerosis

Mesial temporal sclerosis treatments generally consist of managing the epilepsy symptom with the help of either anticonvulsant medication or, if medication is not effective, surgery.

Surgical treatments for intractable epilepsy include a temporal lobectomy or vagal nerve stimulation.

Temporal lobectomy is a surgical procedure that removes the brain tissue in the temporal lobe that causes the seizures. An amygdalohippocampectomy is the surgical removal of the amygdala and the hippocampus after other treatments have failed to provide relief. Neuroimaging allows our expert brain surgeons to carefully target the damaged tissue and allow as much healthy brain tissue as possible to remain.

Additional Treatments

Vagal Nerve Stimulation is a minimally invasive mesial temporal sclerosis treatment that employs an implanted stimulator, which delivers electric impulses to an electrode on the vagal nerve in the neck via a lead wire implanted under the skin. These impulses modulate the brain’s circuitry.

The revolutionary NeuroPace RNS® System uses a pacemaker, similar to ones used in deep brain stimulation to treat Parkinson’s disease, to employ electrical stimulation to normalize brain activity.

Our highly qualified, board-certified neurosurgeons and epilepsy specialists provide expert mesial temporal sclerosis, hippocampal sclerosis, and associated temporal lobe epilepsy. Visit our premier treatment centers in the NY and Long Island areas to talk with one of our experienced neurospecialists.

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Brian Snyder

M.D., F.A.N.N.S.


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