High resolution MR technique in the diagnosis of mesial temporal sclerosis correlative MRI and pathological features

Mesial temporal sclerosis, otherwise known as hippocampal sclerosis, is the most common entity associated with medically intractable temporal lobe epilepsy. The neuronal loss and gliosis of the hippocampus that is pathologically characteristic of this disorder is thought to serve as an epileptogenic substrate. Accurate identification and localization of this pathology is crucial before surgery is considered to potentially cure medically intractable seizures. Magnetic resonance imaging plays a central role in the presurgical work-up. We present a 44-year-old man with a history of intractable partial complex seizures secondary to right-sided mesial temporal sclerosis and discuss the magnetic resonance imaging findings utilizing a high resolution technique.