Title |
International consensus classification of hippocampal sclerosis in temporal lobe epilepsy: A Task Force report from the ILAE Commission on Diagnostic Methods
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Published in |
Epilepsia, May 2013
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DOI | 10.1111/epi.12220 |
Pubmed ID | |
Authors |
Ingmar Blümcke, Maria Thom, Eleonora Aronica, Dawna D. Armstrong, Fabrice Bartolomei, Andrea Bernasconi, Neda Bernasconi, Christian G. Bien, Fernando Cendes, Roland Coras, J. Helen Cross, Thomas S. Jacques, Philippe Kahane, Gary W. Mathern, Haijme Miyata, Solomon L. Moshé, Buge Oz, Çiğdem Özkara, Emilio Perucca, Sanjay Sisodiya, Samuel Wiebe, Roberto Spreafico |
Abstract |
Hippocampal sclerosis (HS) is the most frequent histopathology encountered in patients with drug-resistant temporal lobe epilepsy (TLE). Over the past decades, various attempts have been made to classify specific patterns of hippocampal neuronal cell loss and correlate subtypes with postsurgical outcome. However, no international consensus about definitions and terminology has been achieved. A task force reviewed previous classification schemes and proposes a system based on semiquantitative hippocampal cell loss patterns that can be applied in any histopathology laboratory. Interobserver and intraobserver agreement studies reached consensus to classify three types in anatomically well-preserved hippocampal specimens: HS International League Against Epilepsy (ILAE) type 1 refers always to severe neuronal cell loss and gliosis predominantly in CA1 and CA4 regions, compared to CA1 predominant neuronal cell loss and gliosis (HS ILAE type 2), or CA4 predominant neuronal cell loss and gliosis (HS ILAE type 3). Surgical hippocampus specimens obtained from patients with TLE may also show normal content of neurons with reactive gliosis only (no-HS). HS ILAE type 1 is more often associated with a history of initial precipitating injuries before age 5 years, with early seizure onset, and favorable postsurgical seizure control. CA1 predominant HS ILAE type 2 and CA4 predominant HS ILAE type 3 have been studied less systematically so far, but some reports point to less favorable outcome, and to differences regarding epilepsy history, including age of seizure onset. The proposed international consensus classification will aid in the characterization of specific clinicopathologic syndromes, and explore variability in imaging and electrophysiology findings, and in postsurgical seizure control. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Mexico | 1 | 14% |
Netherlands | 1 | 14% |
Canada | 1 | 14% |
Norway | 1 | 14% |
United Kingdom | 1 | 14% |
Egypt | 1 | 14% |
Unknown | 1 | 14% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 4 | 57% |
Practitioners (doctors, other healthcare professionals) | 1 | 14% |
Science communicators (journalists, bloggers, editors) | 1 | 14% |
Scientists | 1 | 14% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 4 | <1% |
Switzerland | 2 | <1% |
France | 2 | <1% |
Brazil | 2 | <1% |
Netherlands | 2 | <1% |
Italy | 1 | <1% |
Mexico | 1 | <1% |
Czechia | 1 | <1% |
Japan | 1 | <1% |
Other | 1 | <1% |
Unknown | 772 | 98% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Ph. D. Student | 104 | 13% |
Researcher | 99 | 13% |
Student > Bachelor | 97 | 12% |
Student > Master | 92 | 12% |
Other | 70 | 9% |
Other | 164 | 21% |
Unknown | 163 | 21% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 260 | 33% |
Neuroscience | 133 | 17% |
Agricultural and Biological Sciences | 59 | 7% |
Biochemistry, Genetics and Molecular Biology | 34 | 4% |
Psychology | 22 | 3% |
Other | 79 | 10% |
Unknown | 202 | 26% |