• Isolated hippocampal sclerosis...

*Result*: Isolated hippocampal sclerosis and focal dysplasia type IIIa: Comparative study of anatomo-electro-clinical profile and seizure outcome.

Title:
Isolated hippocampal sclerosis and focal dysplasia type IIIa: Comparative study of anatomo-electro-clinical profile and seizure outcome.
Authors:
Mahmoud MB; Van Gogh Epileptology Unit, Department of Neurology, CIC 1414, University Hospital (CHU) of Rennes, 2 rue Henri-Le-Guilloux, Rennes Cedex 9, 35033, France; Department of Neurology University Hospital (CHU) Charles Nicolle, Boulevard 9 Avril 1938, Tunis 1006 Tunisia. Electronic address: mariem.ben.mahmoud89@gmail.com., Benard A; Van Gogh Epileptology Unit, Department of Neurology, CIC 1414, University Hospital (CHU) of Rennes, 2 rue Henri-Le-Guilloux, Rennes Cedex 9, 35033, France; University of Rennes 1, INSERM, LTSI-U1099, 35000 Rennes, Campus de Beaulieu, Bât 22, 35042 Cedex, Rennes, France. Electronic address: Adrien.BENARD@chu-rennes.fr., Taussig D; Université Paris Saclay-APHP, Neurophysiology and Epileptology, 78, avenue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France. Electronic address: delphine.taussig@aphp.fr., Trebon P; Van Gogh Epileptology Unit, Department of Neurology, CIC 1414, University Hospital (CHU) of Rennes, 2 rue Henri-Le-Guilloux, Rennes Cedex 9, 35033, France. Electronic address: pascaletrebon@sfr.fr., Chiforeanu DC; Department of Anatomic Pathology and Cytopathology, University Hospital (CHU) - Rennes, France 2 rue Henri-Le-Guilloux, Rennes Cedex 9, 35033, France. Electronic address: Dancristian.CHIFOREANU@chu-rennes.fr., Sahler Y; Department of Neurosurgery, University Hospital (CHU), Rennes, 2 rue Henri-Le-Guilloux, Rennes Cedex 9, 35033, France. Electronic address: Yves.SAHLER@chu-rennes.fr., Biraben A; Van Gogh Epileptology Unit, Department of Neurology, CIC 1414, University Hospital (CHU) of Rennes, 2 rue Henri-Le-Guilloux, Rennes Cedex 9, 35033, France; University of Rennes 1, INSERM, LTSI-U1099, 35000 Rennes, Campus de Beaulieu, Bât 22, 35042 Cedex, Rennes, France. Electronic address: arnaud.biraben@univ-rennes1.fr., Nica A; Van Gogh Epileptology Unit, Department of Neurology, CIC 1414, University Hospital (CHU) of Rennes, 2 rue Henri-Le-Guilloux, Rennes Cedex 9, 35033, France; University of Rennes 1, INSERM, LTSI-U1099, 35000 Rennes, Campus de Beaulieu, Bât 22, 35042 Cedex, Rennes, France. Electronic address: Anca.NICA@chu-rennes.fr., Maliia MD; Van Gogh Epileptology Unit, Department of Neurology, CIC 1414, University Hospital (CHU) of Rennes, 2 rue Henri-Le-Guilloux, Rennes Cedex 9, 35033, France; University of Rennes 1, INSERM, LTSI-U1099, 35000 Rennes, Campus de Beaulieu, Bât 22, 35042 Cedex, Rennes, France. Electronic address: Dragos-mihai.maliia@chu-rennes.fr.
Source:
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology [Clin Neurophysiol] 2026 Jan; Vol. 182, pp. 2111461. Date of Electronic Publication: 2025 Nov 29.
Publication Type:
Journal Article; Comparative Study
Language:
English
Journal Info:
Publisher: Elsevier Country of Publication: Netherlands NLM ID: 100883319 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-8952 (Electronic) Linking ISSN: 13882457 NLM ISO Abbreviation: Clin Neurophysiol Subsets: MEDLINE
Imprint Name(s):
Original Publication: Amsterdam : Elsevier, c1999-
MeSH Terms:
Hippocampus*/pathology , Hippocampus*/physiopathology , Hippocampus*/diagnostic imaging , Hippocampus*/surgery , Epilepsy, Temporal Lobe*/physiopathology , Epilepsy, Temporal Lobe*/surgery , Epilepsy, Temporal Lobe*/pathology , Malformations of Cortical Development*/physiopathology , Malformations of Cortical Development*/surgery , Malformations of Cortical Development*/pathology , Seizures*/physiopathology , Seizures*/surgery , Drug Resistant Epilepsy*/physiopathology , Drug Resistant Epilepsy*/surgery, Sclerosis/physiopathology ; Electroencephalography/methods ; Humans ; Female ; Male ; Adult ; Retrospective Studies ; Middle Aged ; Young Adult ; Treatment Outcome ; Adolescent ; Follow-Up Studies ; Hippocampal Sclerosis ; Epilepsy ; Malformations of Cortical Development, Group I
Contributed Indexing:
Keywords: Drug-resistant epilepsy; Epilepsy surgery; Focal cortical dysplasia; Hippocampal sclerosis; Seizure outcome; Temporal lobe epilepsy
SCR Disease Name:
Focal cortical dysplasia of Taylor
Entry Date(s):
Date Created: 20251206 Date Completed: 20260111 Latest Revision: 20260113
Update Code:
20260130
DOI:
10.1016/j.clinph.2025.2111461
PMID:
41352305
Database:
MEDLINE

*Further Information*

*Objective: Distinguishing drug-resistant temporal lobe epilepsy (TLE) caused by isolated hippocampal sclerosis (iHS) from focal cortical dysplasia type IIIa (FCD IIIa) remains a presurgical challenge. This study aimed to compare the clinical characteristics, electrophysiological data, and postsurgical seizure outcomes between these pathologies.
Methods: We retrospectively analyzed a cohort of 50 consecutive TLE patients (mean duration of disease of 22 years) who underwent surgery. The histopathology confirmed either iHS (n = 22) or FCD IIIa (n = 28) and a minimum follow-up of 12 months. The groups were compared on complex presurgical data, surgery type, and outcome.
Results: A history of febrile seizures (p = 0.02, OR = 4.7) was more frequent in the FCD IIIa group, which also had significantly lower intelligence quotient (IQ) scores in all domains. The mean total IQ score for FCD IIIa/iHS was 86/94 (p = 0.02); verbal IQ was 85/92 (p = 0.03); performance IQ was 89/98 (p = 0.02). The effect size was considered medium for all three (Cohen's d = 0.7, 0.63 and 0.68 respectively). Scalp EEG showed shorter seizures in FCD IIIa (p = 0.03), in SEEG, the temporal pole was more implanted in this group (p = 0.02, 50 % difference, OR = ∞). At a mean follow-up of 8.5 years, similar seizure-freedom rates was found between groups (82 % for FCD IIIa, 95 % for iHS; p = 0.48). Follow-up EEG and neuropsychological assessment at 6 months post-surgery showed no statistical differences.
Significance: FCD IIIa and iHS exhibit several distinct electro-clinical features. The most important is a more impaired general cognitive profile associated with FCD IIIa, without differences in language or global memory.
(Copyright © 2025 The Author(s). Published by Elsevier B.V. All rights reserved.)*

*Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.*