Alterazioni transitorie di risonanza magnetica nell'epilessia del lobo temporale

MRI obtained soon after prolonged seizures can show transient focal abnormalities. It Is still debated whether these alterations are the cause or the consequence of the seizures. This study describes the electroclinical and MRI features of three patients with temporal lobe epilepsy (TLE), in which MRI detected transient abnormalities in the mesial temporal structures in close temporal relationship with a secondary generalized seizure or recurrent partial seizures. In all patients MRI showed hyperintense signal in T2-weighted images and a volume increase of amygdala and hippocampus, extended to the uncus, temporal pole and insula in one case, with enhacement in another one. On follow-up imaging, the abnormalities gradually resolved, leaving hippocampal sclerosis (HS) in two cases. In all patients the electroclinical data were congruent with the side of the MRI alterations. The evolution to HS observed In two cases support the hypothesis that this pathologic entity may develop in adulthood after repeated seizures.