Mesial Temporal Syndrome (MTS)

MTS consists of seizures originating from the mesial temporal structures, with hippocampal sclerosis as their pathological substrate. In surgical series the majority of patients with intractable temporal lobe epilepsy have evidence of hippocampal sclerosis. A strong association of MTS with early childhood prolonged febrile seizures was identified in both surgical and nonsurgical series, with a prolonged seizure-free interval after a febrile or afebrile period, in many patients. Characteristic seizure semiology includes epigastric or psychic auras, followed by decreased behavioural activity or staring, slowly progressive clouding of consciousness, oroalimentary and manual automatisms and autonomic phenomena. Memory dysfunction is the most important neuropsychological feature in patients with MTS. Temporal lobe epilepsy due to MTS is intractable to medical treatment in a high percentage of patients. The seizure outcome after mesial temporal resection is considered as the most favourable among all surgically remediable epilepsies.
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