title: Mesial temporal lobe epilepsy: clinical and neuropathologic findings of familial and sporadic forms.
abstract: OBJECTIVE
  To evaluate the clinical and hippocampal histological features of patients with mesial temporal lobe epilepsy (MTLE) in both familial (FMTLE) and sporadic (SMTLE) forms.
  
  
  METHODS
  Patients with FMTLE (n = 20) and SMTLE (n = 39) who underwent surgical treatment for refractory seizures were studied at the University of São Paulo School of Medicine at Ribeirão Preto. FMTLE was defined when at least two individuals in a family had clinical diagnosis of MTLE. Hippocampi from all patients were processed for Nissl/HE and Timm's stainings. Both groups were compared for clinical variables, hippocampal cell densities, and intensity of supragranular mossy fiber staining.
  
  
  RESULTS
  There were no significant differences between FMTLE and SMTLE groups in the following: age at the surgery, age of first usual epileptic seizure, history of initial precipitating injury (IPI), age of IPI, latent period, ictal and interictal video-EEG patterns, presence of hippocampal atrophy and signal changes at MRI, and postoperative outcome. In addition, no differences were found in cell densities in hippocampal cornu ammonis subfields (CA1, CA2, CA3, CA4), fascia dentata, polymorphic region, subiculum, prosubiculum, and presubiculum. However, patients with SMTLE had greater intensity of mossy fiber Timm's staining in the fascia dentata-inner molecular layer (p< 0.05).
  
  
  CONCLUSIONS
  Patients with intractable FMTLE present a clinical profile and most histological findings comparable to patients with SMTLE. Interestingly, mossy fiber sprouting was less pronounced in patients with FMTLE, suggesting that, when compared to SMTLE, patients with FMTLE respond differently to plastic changes plausibly induced by cell loss, neuronal deafferentation, or epileptic seizures.
authors.affiliation: Department of Neurology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. lupatrizia@yahoo.com.br
authors.forename: Luciana Patrízia A
authors.initials: LP
authors.lastname: Andrade-Valença
authors.forename: Marcelo Moraes
authors.initials: MM
authors.lastname: Valença
authors.forename: Tonicarlo Rodrigues
authors.initials: TR
authors.lastname: Velasco
authors.forename: Carlos Gilberto
authors.initials: CG
authors.lastname: Carlotti
authors.forename: João Alberto
authors.initials: JA
authors.lastname: Assirati
authors.forename: Orfa Yineth
authors.initials: OY
authors.lastname: Galvis-Alonso
authors.forename: Luciano
authors.initials: L
authors.lastname: Neder
authors.forename: Fernando
authors.initials: F
authors.lastname: Cendes
authors.forename: João Pereira
authors.initials: JP
authors.lastname: Leite
mesh_terms: D000328:Adult; D038481:Anterior Temporal Lobectomy; D001284:Atrophy; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006624:Hippocampus / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019599:Mossy Fibers, Hippocampal / Q000473:pathology; D009473:Neuronal Plasticity / Q000235:genetics; D009474:Neurons / Q000473:pathology; D012598:Sclerosis