In recent years, mesial temporal lobe epilepsy has been recognized as a distinct epileptic syndrome associated with hippocampal or mesial temporal sclerosis. The pathological process leading to this medically refractory epilepsy acts on the developing brain. In the clinical history, an early, acute, usually convulsive and often febrile episode is followed at a variable latency by recurring seizures, whose clinical symptomatology is consistent with the involvement of limbic structures. Their symptomatology is highly variable ranging from short periods of loss of contact to complex phenomenology including autonomic and emotional manifestations, illusions, hallucinations and automatisms, that can hardly be accounted for by a dysfunction of an individual structure. Although the seizures are refractory to antiepileptics, anteromesial temporal lobectomy can abolish disabling seizures in 80–90% of the patients, and early surgical intervention will prevent psychosocial consequences.
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