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Epilepsy Research Group, Institute of Neurology (Drs. Raymond, Fish, Sisodiya, and Shorvon) and Department of Radiology (Dr. Stevens), National Hospital for Neurology and Neurosurgery, Queen Square, London, UK; and the Neuroscience Department (Dr. Cook), St. Vincents Hospital, Victoria Parade, Fitzroy, Victoria, Australia.
The possible dual occurrence of hippocampal sclerosis (HS) and other structural lesions (especially cortical dysgenesis [CD]) is well established in patients with chronic partial epilepsy. We describe the frequency of additional CD in a series of 100 patients with evidence of HS, using volumetric MRI. Additional, often subtle, CD was present in 15 patients: subependymal heterotopia (six), forme fruste of tuberous sclerosis (two), focal macrogyria (two), focal cortical dysplasia (one), laminar heterotopia (one), bilateral schizencephaly (one), and simplified gyral patterns (two). In contrast, in 46 healthy volunteers, only one had possible CD (p < 0.05). Only 2 of 15 patients had a history of childhood febrile convulsions. HS is a heterogeneous condition; patients being evaluated for temporal lobe surgery should be carefully screened for additional CD using appropriate MR techniques.
Address correspondence and reprint requests to Dr. A.A. Raymond, Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK.
Received March 4, 1994. Accepted in final form April 19, 1994.
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